Document
Initial Medical Exam Form
ICR 202009-0970-012 · OMB 0970-0466 · Object 104976801.
This document may belong to an older filing. More recent activity for OMB 0970-0466:
Document Viewer [docx]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is in progress, but the document is still incomplete and remains in the worker queue. (priority 70 · next 2026-06-18 06:28:53)
Missing: html
Download: Source copy (docx)
Loading document viewer…
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Initial Medical Exam Form |
| Author | Buckley, Kirsten (CDC/OID/NCEZID) |
| File Created | 2021-01-13 |
| Conversion State | partial |