Get Cdc Maritime Conveyance Illness Or Death Investigation Form

This guide provides clear, step-by-step instructions for completing the Cdc Maritime Conveyance Illness Or Death Investigation Form online. Following these instructions will help ensure that all necessary information is accurately submitted to the appropriate authorities.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred PDF editor.
2. At the top of the form, enter the vessel name. This is important for identification purposes.
3. Complete Sections 1 to 4 as instructed. Each section caters to specific information. Notably, all fields marked with red text and an asterisk (*) are mandatory. Ensure to fill these out accurately.
4. Use the form to indicate the type of notification, traveler type, and conveyance type. For every ill or deceased individual, a separate form must be filled out.
5. In Section 2, provide vessel information, including arrival and departure dates as well as the next U.S. port.
6. In Section 3, document the medical history of the ill or deceased person, noting symptoms, conditions, and temperature.
7. Complete Section 4, which relates to the evaluation of the ill or deceased person, including past medications and exposure history.
8. After completing the form, you can submit it via one of the following methods: use the 'Send Via Email' button (ensure your email setup allows for this), or save and send by email as an attachment to MaritimeAdmin@cdc.gov. Alternatively, look for contact information to send by fax or call directly.
9. Section 5 contains personal identifiable information (PII). Only include this section if requested by the quarantine station and make sure to submit by fax or phone instead of email to protect sensitive information.
10. Once submitted, wait for a confirmation email from the CDC within 1-2 business days and reach out to the CDC Quarantine Station if you have not received it or require further assistance.

Complete the Cdc Maritime Conveyance Illness Or Death Investigation Form online today to ensure timely reporting.