Comment on DOS-2026-0694-0008

The requirement in DS-3026 to document **"Tattoos, Scars, and Markings (Submit a photograph of all tattoos, scars, and markings)"** raises concerns regarding medical relevance, privacy, proportionality, and the appropriate scope of a physician's role. The tattoos, scars, and skin markings referenced in this requirement are generally not medical conditions and, by themselves, do not require diagnosis, treatment, or medical intervention. Likewise, many scars and other distinguishing markings have no bearing on an individual's current health status or public health risk. While documenting identifying physical features may serve administrative, identity verification, or security-related purposes, requiring a medical professional to photograph all tattoos, scars, and markings extends beyond the primary purpose of a medical examination. Medical examinations should be limited to assessments that are clinically relevant and necessary to evaluate an individual's health or any applicable public health risks. Requiring comprehensive photographic documentation of tattoos, scars, and other body markings, absent a clear medical justification, may constitute an unnecessary intrusion into an individual's privacy and bodily autonomy. Such requirements should be supported by a legitimate, clearly articulated purpose and should adhere to established principles of medical ethics, including respect for patient dignity, informed consent, confidentiality, and the collection of only the minimum information necessary to fulfill the stated objective. If the purpose of documenting tattoos, scars, and other identifying markings is administrative, identity-related, or security-related rather than medical, that function should be clearly distinguished from the physician's clinical responsibilities. Physicians should not be tasked with collecting non-medical information unless there is a demonstrable clinical or public health justification for doing so. The responsibility for collecting administrative or identification-related information should rest with the appropriate governmental or administrative authority rather than with the examining physician.