[NCEH] Maritime Illness Database and Reporting System (MIDRS)

ICR 202603-0920-012

OMB: 0920-1260

Federal Form Document

IC Document Collections

IC ID	Document Title	Status
252608	Recordkeeping of Engineering and Sanitation Records Form and Instruction	Unchanged
252607	(Passenger) 72-hour Food/Activity History Template (AGE cases) Form and Instruction	Modified
252606	Last Symptom Check and Return to Work Clearance (food and nonfood employees) Form and Instruction	Modified
252605	Interviews to Determine AGE Status (initial, 24-hr, 48-hr)(asymptomatic cabin mates and immediate contacts of symptomatic crew) Form and Instruction	Modified
252603	Three-day Pre-embarkation AGE Illness Assessment (all crew members) Form and Instruction	Unchanged
252602	(CREW) 72-hour Food/Activity History Template (AGE cases) Form	Modified
252599	Recordkeeping of AGE Surveillance Records Form and Instruction	Unchanged
252598	Daily Reports of AGE Logs Form and Instruction	Modified
252597	Special Reports exceeding 2%-3% AGE Threshold (web/phone/email/fax) Form and Instruction	Modified
252596	AGE Illness Report 4 hours before arrival (phone/email/fax) Form and Instruction	Modified
252595	AGE Illness Report 4 hours before arrival (web) Form and Instruction	Modified
252594	AGE Illness Report 24 hours before arrival (phone/email/fax) Form and Instruction	Modified
252593	AGE Illness Report 24 hours before arrival (web) Form and Instruction	Modified