30-Day Notice of Proposed Information Collection: Form DS-1622 and DS-1843, Medical History and Examination for Foreign Service, OMB 1405-0068

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The Department of State has submitted the following information collection request to the Office of Management and Budget (OMB) for approval in accordance with the Paperwork Reduction Act of 1995. Title of Information Collection: Medical History and Examination for Foreign Service. OMB Control Number: 1405-0068. Type of Request: Revision of Currently Approved Collection. Originating Office: Office of Medical Support, M/MED/C/MC. Form Number: DS-1622 and DS-1843. Respondents: Foreign Service Officers, State Department Employees, Other. Government Employees and Family Members. Estimated Number of Respondents: 7,234 per year. Estimated Number of Responses: 7,234 per year. Average Hours per Response: 1.0 hours per response. Total Estimated Burden: 7,234 hours. Frequency: On Occasion. Obligation to Respond: Mandatory.