Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medical Examination for Immigrant or Refugee Applicant Unchanged 660000 660000 290250000 Form and Instruction DS-3025 Vaccination Documentation Worksheet
Form and Instruction DS-3026 Medical History and Physical Examination Worksheet
Form and Instruction DS-2053 Medical Examination for Immigrant or Refugee Applicant
Form and Instruction DS-2054 Medical Examination for Immigrant or Refugee Applicant
Form and Instruction DS-3024 Chest X-Ray and Classification Worksheet
Form and Instruction DS-3030 Tuberculosis Worksheet
Total burden requested under this ICR: 660000 660000 290250000  
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