Information Collection

Medical Clearance Update

IC 264603 under ICR 202503-1405-004 · OMB 1405-0131.

Documents and Forms

Document Name Document Type
Form DS-3057 Medical Clearance Update Form and Instruction
DS-3057 Medical Clearance Update ds3057 - DRAFT - 03-18-2025.pdf Form and Instruction
DS-3057 Medical Clearance Update ds3057 - DRAFT - 03-18-2025.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Clearance Update	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 and Instruction	DS-3057	Medical Clearance Update	ds3057 - DRAFT - 03-18-2025.pdf		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Medical Clearance Update	FR Citation: 88 FR 67857

Number of Respondents: 8,782	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	8,782	8,782
Annual IC Time Burden (Hours)	4,391	4,391
Annual IC Cost Burden (Dollars)	0	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.