Qars

Attachment J - QARS SORN 09-20-0171.pdf

[NCZEID] Traveler Risk Assessment and Management Activities During Disease Outbreaks

QARS

OMB:

Document [pdf]
Download: pdf | pdf
1a`3N5313b3?35713
23

012356789
8
33121
1
2156163273
5

"/[DX/,-#,H0
   

 !"#$%&'$&$()(
*+,-.#"/.-0#12
33
33
3433356
27431
51
81
7
357191123
:;884
5<=<>6
00?68@8688
@
-ABCD,*#EF/++DGDA/,DHI0#913
*+,-.#JHA/,DHIK+L0
@511M1NO7
112
3691833
1
3
3P
33556
@331681
11
3125@535398@8
@6811
7833
1

3125@5353588
@6833
51
@535381
1
3316>Q==8R1
4169S6T27>QUO?S=V66MV=VVV
431
52151N351
312
3?1513W3P1
51
3
1
1
535
E/,-XHCD-+#HG#YIZD[DZB/F+#EH[-C-Z#\*#,]-#*+,-.0#
2552N^31_2
3
1
5111
3
56
33
536P55373
5
3`6151
33
56
61
253P1531
525P331N373P153153
1251222N3

012342325
6789

99
898942233403 !41"32#2"$!
$%3&4324&1101%10'4(22')*3##$+,-./04#2124013442330$#24
1((322320$23"$!24!3014(422322!3#24!3014(3$0251('01)'#$#
(1!1#30#$(114(46$201#4(40(4)$4#$&04#44004#4"$!$#633(3%4##32#274
4!34400322404#3$")1#64403(4#301"$!4#1$400$'!3#2$((3#30"$
#630'0$23$"4&1$'#43&320$21)1(1#132'0323#1$283340893:89;$"
#63')(1<34(#6=3%132>#5
?@8
8A7
89798989=3#1$28334893:89;$"#63')(1
<34(#6=3%13>#5
B@C9DEF6122&2#3!!41#4123$02$#63$0'#$"4#1%1#13253554
G'44#13412$(4#1$7#64#"'("1((<<=H240-I-H22#4#'#$&4'#6$1#&'0323#1$2
8334893:89;$"#63')(1<34(#6=3%13>##$03%3##631#$0'#1$4
#42!1221$4020340$"$!!'14)(3012342325
/3$0243$((3#3063101%10'4(J$ $2'203#30#$64%3)333K0$230#$
231$'2$!!'14)(30123423241%321#$#63L1#30=#4#32"$!"$31$'#132
$12343011#32#4#3$1#34#1$4(!$%3!3#F63233$0243'230#$537
0$'!3#30$#2$"1((322#64#!4&0$2340')(1634(#612J$'161(3$
)$40410(4324!41#1!3%3223(24404#(40:)$03$2212$"032$241%1
"$!"$31$'#132$#4%3(1)3#332#4#32M5,703"$!$#4##41
1%32#14#1$240$#1"14#1$2$"0422332403 63J$ $2'203#30
3K0$2'32#$231$'2$!!'14)(301234232$'$)$404$%3&4341%11
#63L1#30=#4#32"$!4"$31$'#&$#4%3(1"$!$32#4#3$0$223221$#$
4$#63M5871"$!1#34#1$4(4"3034(42#4#3$($4(0')(1634(#64'#6$1#1322$
#64##63234'#6$1#132!4&4##$0$#3#0')(1634(#6$24"3#&M405+7#4J32'6
4#1$253554G'44#13$12$(4#1$74233224&#$03%3##631#$0'#1$4
#42!1221$44020340$"231$'2$!!'14)(301234232"$!032$241%1
1#$#63L1#30=#4#32"$!"$31$'#132$032$2343011#32#4#3$
1#34#1$4(!$%3!3#5
@8
9N99A7
87
9
8989OPQ@

6789

9N9
789B@C9@N9

012456789

59
67
597678678
7958787895

5878
75
567


 !
7
585
997
"
85#859$%78678
8585#8597&8'6
(6

589
85
567
6856789
$
0)2456789

59
67
597
597659585
9758
67758596965785
95867
57785
5"56'5
95785
9758
6656797
$
0*2&58
778787


5
59
67
59
875
57
878567'5
6558
755958565

59765
9585
5857+595


58
750,$+$978529
5785
7856785
7867686'5
7
9
767
77

55-7
85
7
587
67659
5
5
67567
8'5$
0.2456789

59
67
59755857/759+568
785
86
8'5758
7
77
5658
95
657

5659
975
67858758878
$
002
67
85
595759658
7587'95'7968578
785-7
5958
7
698'558
$
012456789

59
67
59752789/538476678965
,$+$85
7
5


78
755587/5457
78758
5878555
$
062&58
7787
59
67
5975958
5976785
78
565

8
67
765
7575958#8578
7778
5786557758#85857
7878756567
59

5
$
082456789

59
67
59767758
597659585

5786676885578
85597#8578
776'5
$
092555'5

57856789
59

56
7688
7

67
965
'777875'7775586'6878
8578
8595588

558
578868878

01213145789
84321
75834787848
00343803211484175148442184780

140
0147847802
9484488452028731
4304517142878
21424
5
414844825784
50121478725284
11484070
9

1
7

401
21
78870431
03
721
778284
1478
78

441
140121314578834584321
7787848
0034380321148417

0703842
942417278400
727
48714847872



32
84070417248

4
3
8
871478400
727
4242114
8
1148434017121


32
144417
1
21
7484144421
02!442814152

77417144281415782
47
44714428141

07848
7

222
1
"914#
14$12140484144281414148
4012114
2
5
0340035
0
%4
17
841
2411474821
70714428141782

7
1077410"782
42814147
44

07848


3222
1

48414&301
44281412028441784840410347
445
070384
2
942417144281417&301
417429412142814117840412
441
44404
'(47802
94
0704172878
214)448224
402428141
718217801212424417%714
7821
77814387047200
01
14
428141*047810178407172030414787
8498427140438
1
78
7
41
2
1
7
7821
7
0704
0844212440028
78121200
0124
+,-./.0123452+63/7./0128,6297,6.4:;2<076.0=.4:;2>//011.4:;2<073.4.4:;2345
?.1@,1.4:2,82<0/,6512.427A029B170CD
97,63:0E2F4187
4
22
474807828G7
84780
<076.0=3H.-.7BE2I
247


32787148
41


281
3280
9380:J3651E
KLMNOPQRSTUVWSPWXY21292040438
1
2%24
0
44147ZZ*073148
0
0140177187323178
[4240017140
014Y11410172
24009

323178
[4


320284231721
2
84784284
447284328920
0
Y400
08214177
2

1439487
0

2050
41
01050121
01

2052

012345671029

7276
711571232162157650115735
37257672626973107122716564176
3271276710

9
2123710676357322271611151710
!"#$%&'()&*+,-&./#011227713253606337117163561

9713267103257106604122711122771
971
325710660416502193701591341
6022711122771
06761576163262571066041227159602131359303542

3012
125512115354323726163101
671573267100317
51770771325360633761
97132
7171065
6976732
35412271591926976732152214671167241
176135276106506

137
7613117735493212326710
7949771
971
9713126164109
56973516232
8609
1026127103541063517267160:96712650
;966573512767352361671035621916167163
7
<.=%+/-.&'()&*+,-&./#071735
9713101027571
6356165071>673561571?6116>174?1>359012
4610
13367356309213015733673501650
6220
37443545771
227165067
6220654123371049352392
71735650921
3472@316773971127373526220
717353
212921561650

622049351:93115727
1157956973106122A692156132
6223451033710612234727312650031731267635411275731
2635461161973510636499

109126502191
923712764132
663616630356017157067603229116291261764157152917676
067661110117531036576353543617356735
10037356261496026193735771
467122716562762
66571071215237337710676
65057671
112635763510261352797107143771
227165641
376435403229120676B1535033096301573310
067661135492103566037765167137157672371232
127371072
1336697310
125513617
323526135901035
5767265071C173175767
312650
C17
3121211

36513771211:9311572D
5
1735715767606763
113711795107012710622
13310715767

01234145676895
8
43854!"""#
$$%&'%"()')"(*&)%) +,,-./''%"(
01'*&'&'%('2.3'
4345/'645786"'9"#:/;4"
8<=>,-899?&&&2%"(9!'""-9"'--'99(''@
99"2
ABCBDCEFDGHDIGJEKLFKHMNG4"""#'"(
""!"'9#!'-
"""#99"O'1"#
'=,+,(-99"434"""2
39'"#9""''"99'2
PQKCBRGSHDHTBUVKWGHDIGXIIUBKKVBKWN
3"-64)34&3-44&"3-;2=-0'2Y,=>-/%
4=+-434)!-=Y,,4Z0-6[2-8-\8
>,>>>2
]FCE^E_HCEFDG`UF_BIaUBNG8!'("?'
(""(''!201
9'9!!5"9!"2&!#
999'bc=d% 'e1!(
(Oc+d"((!("'(
f##1"1"
9!9"'g
)!"(8" @"hi-,,,2
8!#1"""'""-
'1'-#99!#
#!#"' @"!"
9!5"289#1"-
""-"5'""'(9("
9c'('' d#'"-(-#2
9'!(9"('
"""-#!(#"'2

012345722188943215
418






!""!##$
#


%!
&
"&
"!
'3()18)*(+012345943215
418,
-



".

#
!%&

!""
"

!#&%
#&

#
&
#/#
//

&
&"&%

01234503
421'1)1+34*182%
&%
"
&





&
3
%&%"
&
#!


#&##%#
&



#
048)1567158)159435'14)1*(943:*8*3(839);172)<
,
!"=2
$>=?2$@A%
,
%/A!BC&DEBF


File Typeapplication/pdf
File TitleSORN 09-20-0171 _ HHS.gov
Authorxxb4
File Modified2024-11-07
File Created2024-11-07

© 2025 OMB.report | Privacy Policy