Transportation Security Officer Medical Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form TSA Form 1137-1 TRANSPORTATION SECURITY OFFICER MEDICAL CLEARANCE	Form and Instruction	New	Available
1652-0032 TransspSOMQ Emergency ICR memo.pdf	Supplementary Document	Uploaded 2026-06-09	Available
OPMGOVT-5.pdf	Supplementary Document	Uploaded 2016-05-04	Available
OPMGOVT-10 System.pdf	Supplementary Document	Uploaded 2016-05-04	Available
SORN DHSTSA - 022 71 FR 40530 (7172006).pdf	Supplementary Document	Uploaded 2016-05-04	Available
1652-0032 TranspSOMQ 30DN 88 FR 27524 (5.2.2023).pdf	Supplementary Document	Uploaded 2023-05-02	Available
1652-0032 TranspSOMQ 60DN 88 FR 5903 (1.30.2023).pdf	Supplementary Document	Uploaded 2023-05-01	Available
1652-0032 TranspSOMQ SS.docx	Supporting Statement A	Uploaded 2026-06-08	Available
privacy_pia_tsa_hraccess[1].pdf	Supplementary Document	Uploaded 2010-01-15	Available
44 USC 44935.doc	Supplementary Document	Uploaded 2006-09-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
280827	TSO Medical Questionnaire	Form and Instruction	New	TRANSPORTATION SECURITY OFFICER MEDICAL CLEARANCE
191700	Online TSO Medical Questionnaire	Other-Screenshots	Modified

ICR Details

OMB Control No: 1652-0032	ICR Reference No: 202606-1652-003
Status: Active	Previous ICR Reference No: 202305-1652-001
Agency/Subagency: DHS/TSA	Agency Tracking No:
Title: Transportation Security Officer Medical Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 06/10/2026
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/09/2026
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/09/2026
Terms of Clearance: The agency clarified the reasons for its request under 5 CFR 1320.13.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2026	6 Months From Approved	10/31/2026
Responses	36,000	0	22,500
Time Burden (Hours)	43,200	0	37,125
Cost Burden (Dollars)	3,486,680	0	0

---

Abstract: This collection of information will assist the agency in ensuring that candidates under employment consideration for Transportation Security Officer (TSO) positions meet the qualification standards to successfully perform the functions of the position. The information will be collected from applicants for TSO positions to evaluate a candidate's current and past medical history including visual and aural acuity, physical coordination, and motor skills.

Emergency Justfication: Without emergency approval, TSA will risk significant effects to the public’s ability to travel if airports are not able to screen passengers because they do not have sufficient front-line TSOs. TSA’s inability to timely hire TSOs in the needed numbers will translate to increased checkpoint wait times, longer security lines that pose a safety risk, negative impact on TSO moral as mandatory overtime will be necessary, and traveler frustration due to increased risk of flight impacts. The use of normal PRA clearance procedures is reasonably likely to result in public harm such that TSA would be hindered in its ability to hire TSOs in an expeditious manner using the new online solution and TSO Medical Clearance Form.

---

Authorizing Statute(s): US Code: 49 USC 44935
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Online TSO Medical Questionnaire
TSO Medical Questionnaire	TSA Form 1137-1	TRANSPORTATION SECURITY OFFICER MEDICAL CLEARANCE

---

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	36,000	22,500	0	13,500	0	0
Annual Time Burden (Hours)	43,200	37,125	0	6,075	0	0
Annual Cost Burden (Dollars)	3,486,680	0	0	3,486,680	0	0

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: TSA is seeking emergency approval of the revised information collection to replace the prior paper-based SOMQ with the online SOMQ and add the new TSO Medical Clearance Form because delays attributable to the current hiring solution have significantly impacted TSA’s ability to hire sufficient front-line TSOs in many locations. TSA adjusted the number of respondents from 22,500 to 18,000 to more accurately reflect the agency’s current anticipated hiring needs. The annual time burden to respondents has been updated to incorporate the most recent wage data (e.g., the hourly wage rate for TSO candidates). Time burden estimates now reflect a 15-minute reduction resulting from the completion of the SOMQ form online. This form had previously been provided in a written format. In addition, time costs have been updated to account for expenses associated with operating a vehicle to and from the medical appointment. TSA has moved away from using a TSA contracted medical provider to conduct the TSO candidates’ medical exam. As such, the federal cost burden has changed. The government cost no longer includes $2,531,250 in annual fees paid to a contracted medical provider. However, TSO candidates will now incur an out-of-pocket cost to use a local health care provider to conduct a medical exam and complete the new Medical Clearance Form. TSA estimates the cost burden to TSO candidates for medical exams at approximately $2,700,000 (18,000 exams x $150 per exam). Since TSA staff will now be responsible for processing the SOMQ and Medical Clearance Form, cost estimates have been updated to account for the time required by an I-band employee to conduct the necessary review of these medical forms.

---

Annual Cost to Federal Government: $3,488,850

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

---

Common Form ICR:  No

---

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: 06/09/2026

---