Personnel Accountability and Assessment for a Public Health Emergency

OMB 0720-0067

The principal purpose of the DD form 3112, “Personnel Accountability and Assessment Notification for a Public Health Emergency,” is to collect information used to protect the health and safety of individuals working in, residing on, or assigned to DoD installations, facilities, field operations, and commands, and to protect the DoD mission.

The latest form for Personnel Accountability and Assessment for a Public Health Emergency expires 2023-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form DD Form 3112 Personnel Accountability and Assessment for a Public Health Emergency Form and Instruction
0720-0067_SSA_1.9.24.docx Supporting Statement A
Personnel Accountability and Assessment for a Public Health Emergency Form and Instruction

All Historical Document Collections

202308-0720-002 Approved without change	Revision of a currently approved collection	2024-01-10
202103-0720-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-03-17
202010-0720-001 Approved without change	Revision of a currently approved collection	2020-10-19
202009-0720-001 Approved with change	New collection (Request for a new OMB Control Number)	2020-09-17