DEA Voluntary Wellness Program Healthcare Provider Clearance

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
DEA Voluntary Wellness Program DEA Form 315c Supporting Statement A FINAL.docx	Supporting Statement A	Uploaded 2025-11-24	Repair queued
DEA Voluntary Wellness Program DEA Form 315c Supporting Statement A FINAL.docx	Supporting Statement A	Uploaded 2025-11-24	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
276793	DEA Voluntary Wellness Program Healthcare Provider Clearance		New

ICR Details

OMB Control No:	ICR Reference No: 202507-1117-003
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: DOJ/DEA	Agency Tracking No:
Title: DEA Voluntary Wellness Program Healthcare Provider Clearance
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 01/16/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/24/2025
Terms of Clearance: Withdrawn at agency request. Respondents are federal employees responding as part of their job and thus DOJ does not need PRA approval for this collection.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The collection of information via the DEA-315 form is necessary to determine whether DEA employees are medically cleared to safely participate in physical fitness activities under the Voluntary Wellness Program (VWP). This requirement is both a matter of workplace safety and an essential component of the agency’s broader health and wellness initiatives. Pursuant to DEA Personnel Manual 2792, employees must submit a health assessment completed by a licensed medical professional prior to engaging in VWP activities. This process ensures that participation is medically appropriate based on the individual's current health status and minimizes the risk of injury or exacerbation of existing conditions.

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Authorizing Statute(s): None

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:
	90 FR 36453	08/04/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 53000	11/24/2025
Did the Agency receive public comments on this ICR? No

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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
DEA Voluntary Wellness Program Healthcare Provider Clearance

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Initial deployment of form/collection. Form necessary for receiving medical clearance to participate in the Voluntary Wellness Program. Medical appointments to complete the form are at voluntary cost to employees wishing to participate and thus are at 0 cost to the Federal Government.

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Annual Cost to Federal Government:

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: 11/24/2025

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