OMB control number

Report of Physical Examination

OMB 0420-0549 · PEACE.

OMB 0420-0549

The information contained in the Report of Physical Examination will be used to make an individualized determination as to whether an Applicant for Volunteer service will, with reasonable accommodation, be able to perform the essential functions of a Peace Corps Volunteer and complete a tour of service without undue disruption due to health problems.

The latest form for Report of Physical Examination expires 2027-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form PC-1790-S Report of Physical Examination Form and Instruction
Report_Physical_Exam_Justification.docx Justification for No Material/Nonsubstantive Change
PC-17.pdf Supplementary Document
Supporting Statement 0420-0549 Report of Physical Examination.docx Supporting Statement A
Report of Physical Examination Form and Instruction

All Historical Document Collections

202408-0420-001	Reinstatement without change of a previously approved collection	2024-08-23
202011-0420-004	Reinstatement with change of a previously approved collection	2020-11-17
201611-0420-002 Approved without change	Revision of a currently approved collection	2017-02-07
201401-0420-003 Approved with change	Extension without change of a currently approved collection	2014-02-10
201201-0420-001 Approved with change	New collection (Request for a new OMB Control Number)	2012-01-30