Medical History and Examination

OMB 1405-0068

OMB 1405-0068

The documents are necessary to the Foreign Service Act of 1980, as amended (22 U.S.C. 4084, 3901, 3984). They are used to document results of the Foreign Service Medical History and Examination for preemployment decisions. Every person who has been given a conditional offer of employment for Foreign Service with the Department of State (DOS) must be healthy and able to travel to post of assignment worldwide. Those who are not able to travel and serve world wide are not hired. Without these forms, DOS would not have a consistent and fair means to document that each new employee meets the medial criteria for world wide employment in the Foreign Service and family health care needs be met at overseas posts.

The latest form for Medical History and Examination expires 2023-10-31 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form and Instruction
Justification for No Material/Nonsubstantive Change
Justification for No Material/Nonsubstantive Change
Supplementary Document
Supplementary Document
Supplementary Document
Supporting Statement A
All Historical Document Collections
Approved without change
No material or nonsubstantive change to a currently approved collection 2023-12-17
Approved without change
No material or nonsubstantive change to a currently approved collection 2023-07-10
Approved with change
Revision of a currently approved collection 2023-01-26
Approved with change
Revision of a currently approved collection 2020-08-13
Approved without change
Revision of a currently approved collection 2017-06-20
Approved without change
No material or nonsubstantive change to a currently approved collection 2016-03-01
Approved with change
No material or nonsubstantive change to a currently approved collection 2015-02-20
Approved without change
Revision of a currently approved collection 2014-02-25
Approved with change
Revision of a currently approved collection 2013-08-16
Approved without change
Revision of a currently approved collection 2011-09-20
Withdrawn and continue
Revision of a currently approved collection 2010-10-25
Approved without change
Revision of a currently approved collection 2009-02-27
Approved without change
Extension without change of a currently approved collection 2006-03-24
Approved without change
Extension without change of a currently approved collection 2002-07-19
Approved without change
No material or nonsubstantive change to a currently approved collection 2001-09-04
Approved without change
Extension without change of a currently approved collection 2001-06-21
Approved without change
Reinstatement with change of a previously approved collection 2001-04-09
Approved without change
Reinstatement with change of a previously approved collection 1991-09-26
Approved with change
No material or nonsubstantive change to a currently approved collection 1989-04-19
Approved without change
New collection (Request for a new OMB Control Number) 1986-12-31

© 2024 OMB.report | Privacy Policy