Statement in Support of Application for Waiver of Inadmissibility
under Immigration and Nationality Act
(OMB Control No. 0920-0006)
Contact:
Rudith Vice
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention
1600 Clifton Road, NE
Atlanta, Georgia 30333
Phone: (404) 718-7292
Email: nhr9@cdc.gov
1. Respondent Universe and Sampling Methods 2
2. Procedures for the Collection of Information 2
3. Methods to maximize Response Rates and Deal with No Response 2
4. Tests of Procedures or Methods to be Undertaken 2
5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data 2
This information collection does not involve statistical methods.
The respondent universe is any alien applicant for immigration to the United States who is attempting to pursue a waiver of an inadmissible health condition based on a mental disorder with associated harmful behavior. There are no sampling methods employed. The collection of information is authorized under immigration statute and regulation.
CDC form 4.422-1 is generated by CDC with Part I completed with information provided on the DHS/USCIS waiver form (I-601or I-602), which includes the race/ethnicity of the applicant. Part II and III must be completed by the U.S. medical facility or specialist, and by the applicant and applicant’s sponsor. The completed statement must be reviewed by CDC before an applicant is approved for a waiver. The medical evaluation report from the U.S. medical facility or specialist is furnished to CDC to confirm that the individual did report to the U.S. medical facility or specialist and that an initial evaluation was done in compliance with the terms, conditions, and controls imposed by the waiver.
In detail, the process proceeds as follows:
The alien contacts the consular officer or DHS/USCIS officer to obtain the DHS/USCIS form I-601 (for immigrants) or I-602 (for refugees).
The alien completes form I-602/I-602 and files with DHS/USCIS.
The receiving DHS/USCIS office in the U.S. sends the medical documents and the I-601/I-602 form to CDC/DGMH for review.
CDC/DGMH reviews the medical information submitted to determine if the applicant meets the medical requirements for a waiver under Section 212(a)(1)(A)(iii)(I) or (II) as outlined above.
If the request for a waiver is under Section 212(a)(1)(A)(iii)(I) or (II), DGMH issues and completes Part I of CDC Form 4.422-1 as the Reviewing Official.
CDC then sends the form back to the requesting DHS/USCIS office. As applicable, that office, in turn, forwards CDC Form 4.422-1 to the applicant’s sponsor in the U.S. for completion.
The applicant’s sponsor locates a medical facility or specialist in the U.S. who will agree to perform the applicant’s initial evaluation. As applicable, the physician completes Part II of CDC form 4.422-1, indicating that he/she will indeed perform the applicant’s initial evaluation after the applicant admission to the U.S. The applicant (or applicant’s sponsor) completes, as applicable, Part III of CDC form 4.422-1, affirming that the applicant will report to the specialist or facility that completed Part II.
Completed forms are returned to CDC/DGMH for final review. If CDC approves, they will let DHS/USCIS know they support the waiver. DHS/USCIS makes the final decision on whether or not a waiver will be granted. Once the waiver is approved by DHS/USCIS and the applicant is admitted to the United States, the evaluation occurs.
If the process described above is not completed, including the submission of information outlined in CDC Form 4.422-1 to CDC, then a waiver cannot be issued. No response would lead to an alien not receiving a waiver and the alien would remain inadmissible to the United States.
There have been no tests of procedures or methods. CDC has received no complaints regarding the collection of information on CDC form 4.422-1.
No statistical methods are employed in this information collection.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Samuel, Lee (CDC/OID/NCEZID) |
File Modified | 0000-00-00 |
File Created | 2025-07-24 |