Transportation Security Officer Medical Questionnaire

OMB 1652-0032

This collection of information will assist the agency in ensuring that candidates under employment consideration for Transportation Security Officer (TSO) positions meet the qualification standards to successfully perform the functions of the position. The information will be collected from applicants for TSO positions to evaluate a candidate's current and past medical history including visual and aural acuity, physical coordination, and motor skills.

The latest form for Transportation Security Officer Medical Questionnaire expires 2023-07-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form TSA Form 1130A-1 TSO Medical Questionnaire and Evaluation; Travel Form and Instruction
OPMGOVT-5.pdf Supplementary Document
OPMGOVT-10 System.pdf Supplementary Document
SORN DHSTSA - 022 71 FR 40530 (7172006).pdf Supplementary Document
1652-0032 TranspSOMQ 30DN 88 FR 27524 (5.2.2023).pdf Supplementary Document
1652-0032 TranspSOMQ 60DN 88 FR 5903 (1.30.2023).pdf Supplementary Document
1652-0032 TranspSOMQ SS 5.2.2023.docx Supporting Statement A
privacy_pia_tsa_hraccess[1].pdf Supplementary Document
44 USC 44935.doc Supplementary Document
TSO Medical Questionnaire and Evaluation; Travel Form and Instruction

All Historical Document Collections

202305-1652-001 Approved without change	Extension without change of a currently approved collection	2023-05-02
201904-1652-001 Approved without change	Revision of a currently approved collection	2019-07-31
201603-1652-002 Approved without change	Extension without change of a currently approved collection	2016-03-31
201301-1652-006 Approved with change	Reinstatement without change of a previously approved collection	2013-01-29
201203-1652-001 Withdrawn and continue	Extension without change of a currently approved collection	2012-03-30
201001-1652-001 Approved without change	Revision of a currently approved collection	2010-01-22
200608-1652-003 Approved without change	Revision of a currently approved collection	2006-09-25
200503-1652-001 Approved without change	New collection (Request for a new OMB Control Number)	2005-03-01