0920-1352 Critical Contact Sheet 01MAR2022

Form Approved

OMB Approval No. 0920-1352

Expiration Date: 10/31/2024

Critical Contact Sheet

• Primary CDC PHEP project officer-

• Backup CDC PHEP officer or team lead -

• U.S. Marshal –

• Backup Marshall

• Health department emergency operations center (EOC) -

• Continuity of Operations (COOP) EOC:

• EMA EOC:

• Health commissioner, secretary of health, state health officer (SHO), ministry of health -

• *PHEP Director -

• *Medical Countermeasures (MCM) Coordinator -

• MCM Coordinator Backup

• CHEMPACK coordinator -

• Law enforcement agencies responsible for MCM security: security

• Backup law enforcement agency responsible for MCM security:

• Distribution (RSS) lead, supervisor, or chief: name

• Backup distribution lead:

• Department of Health Public information Officer (back-up)

• Influenza program coordinator

• Immunization coordinator

• Laboratorian

• Epidemiologist

• Disabilities/Access and Functional Needs (D/AFN) coordinator or equivalent

Public reporting burden of this collection of information is estimated to average 80 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data 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).