OMB control number

Application for Civil Surgeon Designation

OMB 1615-0114 · DHS/USCIS.

OMB 1615-0114

This information collection is required to determine whether a physician meets the statutory and regulatory requirement for civil surgeon designation.

The latest form for Application for Civil Surgeon Designation expires 2027-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form I-910 Application for Civil Surgeon Designation Form
I910-010-INS-TOC-FeeRule-OPSReview-FR-10172023.docx (document unavailable) Supplementary Document
I-910-010-REV-FeeRuleFinal-Supporting Statement 20230926.docx (document unavailable) Supporting Statement A
privacy-pia-uscis-067-civilsurgeon-june1,2017.pdf Supplementary Document
privacy-pia-064-uscis-myuscis-dec14,2016.pdf Supplementary Document
SORN 007 Benefits Info Sys 2016 10 19.pdf (document unavailable) Supplementary Document
Reference_Citations[1].doc Supplementary Document
Application for Civil Surgeon Designation Form

All Historical Document Collections

202401-1615-022 Approved without change	Revision of a currently approved collection	2024-02-09
202212-1615-018 Comment filed on proposed rule and continue	Revision of a currently approved collection	2023-01-24
202206-1615-002 Approved without change	Extension without change of a currently approved collection	2022-07-26
202007-1615-029 Approved with change	No material or nonsubstantive change to a currently approved collection	2020-08-06
202005-1615-001 Approved with change	Revision of a currently approved collection	2020-05-06
201911-1615-018 Withdrawn and continue	No material or nonsubstantive change to a currently approved collection	2019-11-27
201804-1615-001 Approved without change	Revision of a currently approved collection	2018-05-17
201612-1615-007 Approved without change	No material or nonsubstantive change to a currently approved collection	2016-12-20
201610-1615-039 Approved with change	No material or nonsubstantive change to a currently approved collection	2016-10-25
201510-1615-007 Approved with change	Revision of a currently approved collection	2015-10-30
201307-1615-004 Approved with change	Revision of a currently approved collection	2013-07-31
201009-1615-022 Approved without change	No material or nonsubstantive change to a currently approved collection	2010-10-04
201009-1615-020 Approved without change	Revision of a currently approved collection	2010-09-29
201005-1615-001 Preapproved	New collection (Request for a new OMB Control Number)	2010-05-06