OMB control number
Report of Physical Examination
OMB 0420-0549 ยท 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 is listed under ICR 202408-0420-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 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All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 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 | Revision of a currently approved collection | 2017-02-07 | Approved without change | |
| 201401-0420-003 | Extension without change of a currently approved collection | 2014-02-10 | Approved with change | |
| 201201-0420-001 | New collection (Request for a new OMB Control Number) | 2012-01-30 | Approved with change |