[Federal Register Volume 63, Number 240 (Tuesday, December 15, 1998)]
[Notices]
[Pages 69060-69061]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-33131]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Proposed Collection; Comment Request
AGENCY: Office of the Under Secretary of Defense (Personnel and
Readiness), DoD.
ACTION: Notice.
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In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995, the Office of the Under Secretary of Defense (Personnel
and Readiness) announces the following proposed establishment of DD
Form X376, ``Report of Medical History,'' a public information
collection, and seeks public comment for the provisions thereof.
Comments are invited on: (a) whether the proposed collection of
information is necessary for the proper performance of the functions to
the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of burden of the
proposed information collection; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d)
[[Page 69061]]
ways to minimize the burden of the information collection on
respondents, including use of automated collection techniques or other
forms of information technology.
DATES: Consideration will be given to all comments received by February
16, 1999.
ADDRESSES: Written comments and recommendations on the proposed
information collection should be sent to the Office of the Under
Secretary of Defense (Personnel and Readiness) (Force Management
Policy) (Military Personnel Policy) /Accession Policy, ATTN: LTC
Michael Ostroski, Room 2B271, 4000 Defense Pentagon, Washington, DC
20301-4000.
FOR FURTHER INFORMATION CONTACT: To request more information on this
proposed information collection or to obtain a copy of the proposal and
associated collection instruments, please write to the above address or
call (703) 695-5529.
Title, Associated Form, and OMB Number: ``Report of Medical
History,'' DD Form X376, OMB Control Number 0704-[To be Determined].
Needs and Uses: Title 10, USC Chapter 31: Section 504 and 505, and
Chapter 33: Section 532, requires applicants to meet accession medical
standards prior to enlistment into the Armed Forces (including the
Coast Guard). If applicants' medical history reveals a medical
condition that does not meet the accession medical standards, they are
medically disqualified for military entrance. This form also will be
used by all Service members not only in their initial medical
examination but also for required periodic medical examinations.
Affected Public: Individuals or households
Annual Burden Hours: 256,659
Number of Respondents: 330,000
Responses Per Respondent: 1
Average Burden Per Response: .66 hours per respondent.
Frequency: One time.
SUPPLEMENTAL INFORMATION:
Summary of Information Collection
The new form associated with this information collection will
replace the form currently used by the Department, ``SF 93--Report of
Medical History.'' This new form is needed in order to obtain the
medical information which affects entrance physical examinations,
routine in-service physical examinations, separation physical
examinations, and other medical examinations, as required.
The respondents are all applicants for enlistment, induction or
commissioning. The applicant(s) completes the medical history
information recorded on the form. This information collected provides
the Armed Services with the medical history of applicants. The DD Form
X376 is the method of collecting and verifying medical data on
applicants applying for entrance. This DD Form X376 will be the
official DoD medical document used by the Services through which
historical medical information is collected, reviewed, and maintained.
Dated: December 9, 1998.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 98-33131 Filed 12-14-98; 8:45 am]
BILLING CODE 5000-04-M