NOAA Health Form

        NOAA Health Services Questionnaire form with instructions

        NOAA Form 57-10-2 Tuberculosis Screening Document

        Interactions Between COVID-19 Vaccine and TB Tests

The following are the medical requirements for the upcoming A13.5 2022 GO-SHIP/CO2 Repeat Hydrography Cruise:

         NOAA Health Services Questionnaire (signed and dated)
         Emergency Contact Information
         TB skin test

The date and results of the TB test should be included in the NOAA Health
Services Questionnaire. The NOAA Health Services Questionnaire form,
along with a copy of the TB test result must be sent to NOAA Health Services.
This information can be faxed or emailed. The NOAA Health Services fax number
is 757-441-3760. The email address is Put the
name of the cruise (GOMECC 2021 Cruise) on the fax cover sheet or in the subject
line of the email. This form must reach NOAA Health Services no later than
four weeks prior to the beginning of the cruise. Please notify Betty Huss
( when the medical information has been sent.

       Emergency Contact Information Form

The Emergency Contact Information form must be completed by all cruise
participants. The completed form must be emailed to Betty Huss
( at least one month prior to the beginning of the cruise.

        Emergency Contact Information Form

This web page last updated October 11, 2021