Information Collection

Medical Screening of Military Personnel

IC 5500 under ICR 200701-0704-003 · OMB 0704-0413.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0413 can be found here:

Documents and Forms

Document Name Document Type
Form DD Form 2807-2 Medical Screening of Military Personnel Form
DD Form 2807-1 Report of Medical History 0704-0413 dd2807-1.pdf Form
DD Form 2807-2 Medical Prescreen of Medical History Report 0704-0413 dd2807-2.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Screening of Military Personnel	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 2807-2	Medical Prescreen of Medical History Report	0704-0413 dd2807-2.pdf		Yes	Yes	Fillable Fileable
Form	DD Form 2807-1	Report of Medical History	0704-0413 dd2807-1.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 850,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	850,000	0	850,000
Annual IC Time Burden (Hours)	135,833	0	135,833
Annual IC Cost Burden (Dollars)	761,770	761,770	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.