Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medical History and Examination Modified 2561 2561 0 Form and Instruction DS-1622 Medical History and Examination for Children age 11 and younger
Form and Instruction DS-1843 Medical History and Examination for Children age 12 and older
Total burden requested under this ICR: 2561 2561 0  
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