Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medical Examination for Immigrant or Refugee Applicant New 110412 0 0 Form DS-2054 Report of Medical Examination by Panel Physician
Form DS-3025 Vaccination Documentation
Form DS-3026 Medical History and Physical Examination Worksheet
Form DS-3030 Tuberculosis Worksheet
Medical Examination for Immigrant or Refugee Applicant Unchanged 110412 110412 49685400 Form and Instruction DS-3025 Vaccination Documentation Worksheet
Form and Instruction DS-3026 Medical History and Physical Examination Worksheet
Form and Instruction DS-2054 Medical Examination for Immigrant or Refugee Applicant
Form and Instruction DS-3030 Tuberculosis Worksheet
Total burden requested under this ICR: 220824 110412 49685400  
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