OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

USMS Medical Forms

OMB 1105-0099 ยท DOJ/LA.

OMB 1105-0099

As a law enforcement agency, the United States Marshals Service has unique medical requirements that prevent USMS from using current medical-related Standard and Optional forms. These forms have been developed to allow USMS to ensure that the applicants, contract employees and current federal employees who work in operational law enforcement positions are physically fit enough to perform their duties safely and successfully.

The latest form for USMS Medical Forms expires 2029-01-31 and is listed under ICR 202406-1105-004.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSO-012 SSO-012 Request to Reevaluate Special Security Officer's Medical QualificationsForm and Instruction
Form USM-602 USM-602 Contract Guard Physical Examination ReportForm and Instruction
Form CSO-012 CSO-012 Request to Reevaluate Court Security Officer's Medical QualificationsForm and Instruction
Form USM-522P USM-522P Physician Evaluation Report for USMS Operational Employees - Pregnancy OnlyForm and Instruction
Form USM-522A USM-522A Physician Evaluation Report for USMS Operational EmployeesForm and Instruction
All Except OVW - April ICRs Approved.pdf Supplementary Document
1105-0099-Description of Proposed Changes_20250708.docx Supplementary Document
USM-600 - USMS Security Officer Physical Requirements - Replaced by USM-602 Form.pdf Supplementary Document
1105-0099-Description of Proposed Changes.docx Supplementary Document
usm600-20180104.pdf Supplementary Document
1105-0099 Changes - 2017 - Justification.docx Justification for No Material/Nonsubstantive Change
Memo - USMS.docx Justification for No Material/Nonsubstantive Change
usm522p UPDATED.pdf Supplementary Document
1105-0099-Supporting Statement-2025 Renewal.docxSupporting Statement A
SSO-012 Request to Reevaluate Special Security Officer's Medical Qualifications Form and Instruction
USM-602 Contract Guard Physical Examination Report Form and Instruction
CSO-012 Request to Reevaluate Court Security Officer's Medical Qualifications Form and Instruction
USM-522P Physician Evaluation Report for USMS Operational Employees - Pregnancy Only Form and Instruction
USM-522A Physician Evaluation Report for USMS Operational Employees Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202406-1105-004 Reinstatement with change of a previously approved collection 2025-07-21
201911-1105-001 Extension without change of a currently approved collection 2019-11-26 Approved without change
201712-1105-002 No material or nonsubstantive change to a currently approved collection 2018-01-16 Approved without change
201703-1105-001 No material or nonsubstantive change to a currently approved collection 2017-03-30 Approved without change
201605-1105-001 Revision of a currently approved collection 2016-09-21 Approved without change
201302-1105-001 New collection (Request for a new OMB Control Number) 2013-08-05 Approved without change

OMB Details

USM-522A Physician Evaluation Report for USMS Operational Employees

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
FormNameElectronic accessType
Form USM-522APhysician Evaluation Report for USMS Operational EmployeesFillable PrintableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.