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Documentation of 3-day pre-embarkation AGE illness assessment
ICR 201812-0920-009 · OMB 0920-1260 · Object 89654101.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Documentation of 3-day pre-embarkation AGE illness assessment |
| Author | Etheredge, Alisha (CDC/DDNID/NCEH/OD) |
| Last Modified By | Writer |
| File Modified | 2019-03-01 |
| File Created | 2026-10-10 |
| Conversion State | complete |
Extracted Text
Documentation of 3-day pre-embarkation AGE Illness Assessment for Crew Members Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: Crew member name: AGE Illness assessment: Date completed: CDC estimates the average public reporting burden for this collection of information as 3 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).