Medical Screening of Military Personnel-Medical History Report and Accession Medical History Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD Form 2807-2 Accessions Medical History Report	Form and Instruction	Modified	Repair queued
Form DD Form 2807-1 Report of Medical History	Form	Modified	Available
Form DD Form 2807-1 Medical Screening of Military Personnel	Form	Modified	Repair queued
0704-0413_SSA_10.21.2024 .docx	Supporting Statement A	Uploaded 2024-10-21	Available
0704-0413_SSA_10.21.2024 .docx	Supporting Statement A	Uploaded 2024-10-21	Repair queued
U_USMEPCOM_MIRS-DA00097-PIA Sec1_2024-Draft.pdf	Supplementary Document	Uploaded 2024-09-25	Available
U_USMEPCOM_MIRS-DA00097-PIA Sec1_2024-Draft.pdf	Supplementary Document	Uploaded 2024-09-25	Repair queued
SSN Justification DD Form 2807-1_2807-2_Approval.pdf	Supplementary Document	Uploaded 2021-09-16	Available
SSN Justification DD Form 2807-1_2807-2_Approval.pdf	Supplementary Document	Uploaded 2021-09-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5500	Medical Screening of Military Personnel	Form and Instruction	Modified	Accessions Medical History Report
5500	Medical Screening of Military Personnel	Form	Modified	Report of Medical History
5500	Medical Screening of Military Personnel	Form	Modified

ICR Details

OMB Control No: 0704-0413	ICR Reference No: 202409-0704-012
Status: Active	Previous ICR Reference No: 202109-0704-004
Agency/Subagency: DOW/DODDEP	Agency Tracking No:
Title: Medical Screening of Military Personnel-Medical History Report and Accession Medical History Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/17/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/22/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2028	36 Months From Approved	01/31/2025
Responses	773,003	0	773,003
Time Burden (Hours)	128,834	0	128,834
Cost Burden (Dollars)	934,043	0	934,043

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Abstract: Title 10 U.S.C. Sections 504, 505, 507, 532, 978, 1201, 1202, and 4346 require military applicants to meet medical accession standards for enlistment, induction, and appointment to the Armed Forces. The referenced prescreening and medical history reports are needed from military applicants to elicit an accurate medical history past and present.

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Authorizing Statute(s): US Code: 10 USC 505 Name of Law: Regular Components: Qualifications, Term, Grade
   US Code: 10 USC 532 Name of Law: Qualifications for Original Appointment as a Commissioned Officer
   US Code: 10 USC 978 Name of Law: Drug and Alcohol Abuse and Dependency: Testing of New Entrants
   US Code: 10 USC 507 Name of Law: Extension of Enlistment for Members Needing Medical Care or Hospitalization
   US Code: 10 USC 1201 Name of Law: Regulars and Members on Active Duty for More than 30 Days: Retirement
   US Code: 10 USC 504 Name of Law: Persons Not Qualified
   US Code: 10 USC 1202 Name of Law: Regulars and Members on Active Duty for More than 30 Days: Temporary Disability Retired List
   US Code: 10 USC 4346 Name of Law: Cadets: Requirements for Admission
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 66703	08/16/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 83860	10/18/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Medical Screening of Military Personnel	DD Form 2807-1, DD Form 2807-2	Report of Medical History ,   Accessions Medical History Report

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	773,003	773,003	0	0	0	0
Annual Time Burden (Hours)	128,834	128,834	0	0	0	0
Annual Cost Burden (Dollars)	934,043	934,043	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $3,188,161

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/22/2024

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