OMB control number

NRC Form 396, Certification of Medical Examination by Facility Licensee

OMB 3150-0024 · NRC.

OMB 3150-0024

NRC Form 396 is used to transmit information to the NRC regarding the medical condition of applicants for initial operator licenses or renewal of operator licenses and for the maintenance of medical records for all licensed operators. The information is used to determine whether the physical condition and general health of applicants for operator licensees is such that the applicant would not be expected to cause operational errors and endanger public health and safety.

The latest form for NRC Form 396, Certification of Medical Examination by Facility Licensee expires 2029-04-30 and is listed under ICR 202512-3150-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form NRC Form 396 FORM 396 -CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE	Form and Instruction
Form NRC Form 396 ONLINE FORM -CERTIFICATION OF MEDICAL EXAMINATION BY FACILITY LICENSEE	Form and Instruction
Comment from Duke Energy on Form 396 (4).pdf (document unavailable)	Public Comments
OMB-3150-0024, Final 2025 Collections Renewal Supporting Statement - NRC Form 396, _Certification of Medical Examination by Facility Licensee_ (1) (1) (2).docx	Supporting Statement A
OMB-3150-0024, Final 2025 Collections Renewal Supporting Statement - NRC Form 396, _Certification of Medical Examination by Facility Licensee_ (1) (1) (2).docx	Supporting Statement A
NRC Form 396, Certification of Medical Examination by Facility Licensee	Form and Instruction
NRC Form 396, Certification of Medical Examination by Facility Licensee	Form and Instruction
NRC Form 396, Certification of Medical Examination by Facility Licensee	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202512-3150-001	Extension without change of a currently approved collection	2025-12-23	Approved without change
202303-3150-002	No material or nonsubstantive change to a currently approved collection	2023-03-20	Approved with change
202205-3150-006	Extension without change of a currently approved collection	2022-06-01	Approved with change
201902-3150-003	Extension without change of a currently approved collection	2019-03-05	Approved with change
201707-3150-006	No material or nonsubstantive change to a currently approved collection	2017-07-26	Approved without change
201501-3150-009	Extension without change of a currently approved collection	2015-02-04	Approved with change
201203-3150-001	Extension without change of a currently approved collection	2012-03-15	Approved without change
200810-3150-003	Revision of a currently approved collection	2008-12-04	Approved with change
200511-3150-002	Revision of a currently approved collection	2005-11-10	Approved without change
200211-3150-001	Revision of a currently approved collection	2002-11-08	Approved without change
199910-3150-003	Revision of a currently approved collection	1999-10-25	Approved without change
199610-3150-001	Revision of a currently approved collection	1996-10-10	Approved without change
199310-3150-001	Revision of a currently approved collection	1993-10-15	Approved without change
199107-3150-006	No material or nonsubstantive change to a currently approved collection	1991-07-17	Approved with change
199012-3150-001	Revision of a currently approved collection	1990-12-17	Approved without change
198905-3150-004	No material or nonsubstantive change to a currently approved collection	1989-05-03	Approved with change
198802-3150-004	Reinstatement with change of a previously approved collection	1988-02-26	Approved without change
198411-3150-004	Revision of a currently approved collection	1984-11-26	Approved without change
198205-3150-001	Revision of a currently approved collection	1982-05-14	Approved without change
198104-3150-023	Revision of a currently approved collection	1981-04-01	Approved without change