COVID-19 Vaccine Screening and Immunization Documentation

COVID-19 Vaccine Screening and Immunization Documentation DHA Form 207

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0720-0068 can be found here:

Documents and Forms

Document Name Document Type
Form 207 COVID-19 Vaccine Screening and Immunization Documentation Form and Instruction
207 COVID-19 Vaccine Screening and Immunization Documentatio DHA 207_v11.pdf Form and Instruction
207 COVID-19 Vaccine Screening and Immunization Documentatio DHA 207_v11.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	COVID-19 Vaccine Screening and Immunization Documentation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	4,000,000	-5,000,000	9,000,000
Annual IC Time Burden (Hours)	666,667	-833,333	1,500,000
Annual IC Cost Burden (Dollars)	4,840,000	-6,050,000	10,890,000

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.