[Federal Register: July 23, 2007 (Volume 72, Number 140)]
[Notices]
[Page 40154]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23jy07-52]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
[Document Identifier: OS-0990-0000; 60-day notice]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Office of the Secretary.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Office of the Secretary (OS),
Department of Health and Human Services, is publishing the following
summary of a proposed collection for public comment. Interested persons
are invited to send comments regarding this burden estimate or any
other aspect of this collection of information, including any of the
following subjects: (1) The necessity and utility of the proposed
information collection for the proper performance of the agency's
functions; (2) the accuracy of the estimated burden; (3) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (4) the use of automated collection techniques or other
forms of information technology to minimize the information collection
burden.
Type of Information Collection Request: New.
Title of Information Collection: Report of Medical Examination)--
Form PHS-7059.
Form/OMB No.: 0990-0000.
Use: Health professionals applying to the Commissioned Corps of the
U.S. Public Health Service (Corps) must be medically qualified prior to
appointment. Applicants must have a healthcare provider/physician
complete form PHS-7059, Report of Medical Examination, documenting the
health status of the applicant. The Corps Medical Evaluations Officer
will review the information to ascertain if the applicant is medically
qualified presently and in the near future.
Frequency: One time.
Affected Public: Individuals or Households.
Annual Number of Respondents: 4,000.
Total Annual Responses: 4,000.
Average Burden per Response: 15 minutes.
Total Annual Hours: 1,000 hours.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, e-mail your
request, including your address, phone number, OMB number, and OS
document identifier, to Sherette.funncoleman@hhs.gov, or call the
Reports Clearance Office at (202) 690-6162. Written comments and
recommendations for the proposed information collections must be
received with 60 days, and directed to the OS Paperwork Clearance
Officer at the following address: Department of Health and Human
Services, Office of the Secretary, Assistant Secretary for Resources
and Technology, Office of Resources Management, Attention: Sherrette
Funn-Coleman (0990-0000), Room 537-H, 200 Independence Avenue, SW.,
Washington DC 20201.
Dated: July 11, 2007.
Seleda Perryman,
Office of the Secretary, Paperwork Reduction Act Reports Clearance
Officer.
[FR Doc. E7-14104 Filed 7-20-07; 8:45 am]
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