SUMMARY OF CHANGES
DD FORM 3112
Added:
Section 2, block 5, phone number.
Section 2, block 6, alt phone number.
Section 2, block 7, e-mail address.
Section 2, block 8, e-mail address.
Section 2, block 9, location at time of exposure.
Section 3, block 3, date tested.
Section 3, block 4, date results received.
Section 3, block 5, test results.
Section 3, block 10, point of contact.
Section 3, block 11, Full name of point contact.
Section 3, block 12, organization/office.
Section 3, block 13, relationship to affected individual.
Section 3, block 14, phone number.
Section 3, black 15, e-mail address.
Removed:
Block 2, type of report.
Section V, block 5, Status on Recovery and Return.
Section V, block 6, Notes.
Modified:
Privacy Act statement and Agency Disclosure Notice moved to first page.
Section 2, block 10, 11 and 12 – Travel within the last 30 days information
Section III: Type of Confirmed or Possible Health/Safety Issue (re-organized questions)
Instructions
Terms and Definitions
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Purvis, Lane M CIV WHS ESD (USA) |
| File Modified | 0000-00-00 |
| File Created | 2021-03-18 |