OMB control number
2019 Novel Coronavirus Airport Entry Questionnaires
OMB 0920-1287 · HHS/CDC.
OMB 0920-1287
CDC has been tasked with conducting public health assessments at U.S. airports of travelers coming from areas experiencing an outbreak of a novel (new) coronavirus (named “2019-nCoV”) in order to detect ill individuals or individuals at risk of being ill with 2019-nCoV. The goal of this information collection is to 1) accurately assess risk for infection or exposure to 2019-nCoV in travelers coming to the United States from locations experiencing an outbreak of 2019-nCoV, and 2) assist states in facilitating public health follow-up of contacts in the event of a confirmed case on an aircraft. The information will be used to determine if individuals meet risk thresholds for further medical evaluation or public health follow-up according to guidance developed by the CDC, and to assist health departments in facilitating public health follow-up, as appropriate. The Non-Substantive Change Request described here is being submitted to adjust the burden for travelers coming to this country from Brazil, and also reflects changes in burden as a result of a decreased number of travelers coming to the U.S.
The latest form for 2019 Novel Coronavirus Airport Entry Questionnaires expires 2020-09-30 and is listed under ICR 202005-0920-013.
Latest Forms, Documents, and Supporting Material
Form 0920-20HF COVID-2019 Air Traveler Illness and Death Investigation Form
Form 0920-20HF Preboarding Health Screen
COVID-2019 Air Traveler Illness and Death Investigation FormAll Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202005-0920-013 | No material or nonsubstantive change to a currently approved collection | 2020-05-26 | Approved without change | |
| 202003-0920-007 | No material or nonsubstantive change to a currently approved collection | 2020-03-16 | Approved without change | |
| 202001-0920-020 | New collection (Request for a new OMB Control Number) | 2020-03-09 | Approved with change |
OMB Details
United States Traveler Health Declaration
Federal Enterprise Architecture: Health - Public Health Monitoring
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form 0920-1287 | U.S. Traveler Health Declaration England/Ireland Paper | NA | Form and instruction |
| Form 0920-20HF | US Traveler Health Declaration Paper | Paper Only | Form and instruction |
| Form 0920-20HF | US Traveler Health Declaration Fillable PDF | Fillable Fileable | Form and instruction |
| Form 0920-20HF | US Traveler health Declaration Web | Fillable Fileable | Form and instruction |
| Form 0920-1287 | US Traveler Health Declaration - Brazil - Paper Format | NA | Form and instruction |
| Form 0920-1287 | U.S. Traveler Health Declaration England/Ireland Fillable PDF | NA | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.