PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Follow-up to Request for Clinical & Medical Treatment Records
Unchanged
500
25
0
Form and Instruction
NA Form 13177
Follow-up to Request for Clinical & Medical Treatment Records
Forms Relating to Military Service Records
Modified
132500
11042
0
Form and Instruction
NA Form 13036
Authorization for Release of Military Medical Patient Records
Form and Instruction
NA Form 13042
Request for Information Needed to Locate Medical Records
Form and Instruction
NA Form 13055
Request for Information Needed to Reconstruct Medical Data
Form and Instruction
NA Form 13075
Questionnaire about Military Service
Form and Instruction
NA Form 13177
Check the Status of a Clinical & Medical Treatment Records Request
Total burden requested under this ICR:
133000
11067
0
To view an IC, click on IC Title
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