Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Health History Form (PC 1789) New 10000 7500 0 Form and Instruction PC-1789 Health History Form
Form and Instruction PC-1789 Health History Form (paper version)
Health Status Review Removed 0 0 0 Form and Instruction PC-1789 Health Status Review
Report of Medical Examination Removed 0 0 0 Form and Instruction PC-1790S Report of Medical Examination
Total burden requested under this ICR: 10000 7500 0  
To view an IC, click on IC Title