Medical Examination for Immigrant or Refugee Applicant

Documents and Forms

Document Name Document Type
Form DS-3025 Medical Examination for Immigrant or Refugee Applicant Form and Instruction
Form DS-3025 Medical Examination for Immigrant or Refugee Applicant Form and Instruction
DS-3025 Vaccination Documentation Worksheet DS-3025 COVID Update.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Medical Examination for Immigrant or Refugee Applicant	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-3025	Vaccination Documentation Worksheet	DS-3025 COVID Update.pdf		No		Paper Only

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title: SORN Visa Records, State-39	FR Citation: 60 FR 148

Number of Respondents: 110,412	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	110,412	110,412
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.