Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps

OMB 0937-0025

The forms will be used by individuals to apply for appointment in the U.S. Public Health Service Commissioned Corps and to obtain references as part of the application process. Information supplied on the forms will be used by appropriate Department officials to evaluate candidates for appointment.

The latest form for Reference Request for Applicants to the U.S. Public Health Service Commissioned Corps expires 2023-12-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form PHS-50 PHS-50 Form and Instruction
Form PHS-1813 PHS-1813 Form
SS-A 0937-0025 PHS 50 and PHS 1813 revised (6).docx Supporting Statement A
2023-27974 60 Day Notice 2023.pdf Supplementary Document
PHS-50 Form and Instruction
PHS-1813 Form
Addendum: Commissioned Corps Personal Statement Other-Personal Statement
Interested Health Professionals

All Historical Document Collections

202312-0937-001 Approved with change	Revision of a currently approved collection	2023-12-29
202008-0937-001 Approved without change	Revision of a currently approved collection	2020-10-14
201911-0937-001 Approved with change	Revision of a currently approved collection	2019-12-27
201607-0937-001 Approved without change	Extension without change of a currently approved collection	2016-09-12
201310-0937-002 Approved without change	Extension without change of a currently approved collection	2013-10-29
201007-0937-001 Approved without change	Reinstatement with change of a previously approved collection	2010-07-02
200612-0937-001 Approved without change	Extension without change of a currently approved collection	2006-12-28
200307-0937-001 Approved with change	Revision of a currently approved collection	2003-07-29
200005-0937-001 Approved without change	Revision of a currently approved collection	2000-05-12
199706-0937-001 Approved without change	Revision of a currently approved collection	1997-06-11
199403-0937-002 Approved without change	Revision of a currently approved collection	1994-03-22
199105-0937-002 Approved with change	No material or nonsubstantive change to a currently approved collection	1991-05-07
199102-0937-001 Approved without change	Revision of a currently approved collection	1991-02-05
198801-0937-004 Approved without change	Revision of a currently approved collection	1988-01-28
198412-0937-005 Approved without change	Revision of a currently approved collection	1984-12-27
198212-0937-001 Approved without change	Revision of a currently approved collection	1982-12-23
197805-0937-001 Approved without change	New collection (Request for a new OMB Control Number)	1978-05-31

OMB Details

PHS-50

Federal Enterprise Architecture: Health - Health Care Services