OMB control number

FEMA Reasonable Accommodation Medical Request Form

OMB 1660-0171 · DHS/FEMA.

OMB 1660-0171

FEMA’s new form supports a fair, efficient, and consistent process for evaluating employee requests for reasonable accommodations. It ensures that medical information is collected by license health care providers, helping the agency make informed decisions. FEMA is streamlining the process by ensuring that all necessary and relevant information is consistently captured. By providing a clear and uniform structure, it enhances efficiency for employees and licensed health care providers, while reducing the potential for delays caused by incomplete or insufficient submissions of medical documentation.

The latest form for FEMA Reasonable Accommodation Medical Request Form expires 2029-04-30 and can be found here.

REPLACE INTO tbl_reginfo_omb_history (`ombControlNo`, `refNbr`, `PraType`, `requestType`, `dateReceived`, `conclusionDate`, `conclusionAction`, `openNOA`) VALUES (:ombControlNo, :refNbr, :PraType, :requestType, :dateReceived, :conclusionDate, :conclusionAction, :openNOA)

Array
(
    [ombControlNo] => 1660-0171
    [refNbr] => 202601-1660-001
    [PraType] => ICR
    [requestType] => New collection (Request for a new OMB Control Number)
    [dateReceived] => 2026-02-13
    [conclusionDate] => 2026-04-02
    [conclusionAction] => Approved without change
    [openNOA] => Approved without change
)

Error!HY000-1366-Incorrect integer value: 'Approved without change' for column 'openNOA' at row 1