The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Resilient Program Attestation Form COVID-19 Health & Safety Protocols Form #: OCG 2020 -002F Updated November 25, 2020 Page 1 of 1 Licensee Name Licensee No: Address of Licensed Location Street Number & Name Suite No. recovery from COVID-19 and clearance to travel and collect a passenger attestation on behalf of the U.S. Centers for Disease Control and Prevention (CDC) for certain passengers on aircraft departing from a foreign country and arriving in the United States. Featured photo by Zach Griff/The Points Guy Duke Health CDC High-Risk Redeployment Attestation Form. Coronavirus (COVID-19) Home Page. Managers to email completed form to . Attestation form is to be used for each location that is opened. (If Applicable) City, State & Zip Code Licensed Location Maximum Occupancy Information The CDC said earlier this year that air passengers would be required to confirm that the information they present “is true in the form of an attestation.” The CDC also said that airlines are responsible for ensuring any translation accuracy and may not shift this responsibility to a third party. The certificate requires each visiting adult to complete and sign an attestation that he or she has had a negative test for COVID-19 consistent with CDC guidance, has had COVID-19 in the previous 90 days, has been fully vaccinated for COVID-19, or agrees to comply with Maine’s quarantine. Employee . Name: Department: Job Title: Shift: Duke . How to Use this Document – Individuals, Families, Guardians and Support Coordinators can be used by families to guide ... the CDC can be found at: • COVID-19 Daily Activities and Going Out. To comply with the CDC order and quarantine in Hawaii: The following must be completed for all travelers two (2) years and older prior to boarding. designated entity HR representative (customize). The affidavit created by the CDC Director Dr. Rochelle Walensky signed a declaration determining that the evictions of tenants could be detrimental to public health control measures to slow the spread of SARS-Cov-2, the virus that causes COVID-19. with Duke Health Temporary COVID-19 Work Modification Approval Form. confirm that the information they present is true in the form of an attestation. Every traveler two (2) years and older will need to submit the form. This Order is effective as of 12:01am EST (5:01am GMT) on January 26, 2021. Each individual 2 yares of age or older must provide a separate attestation. details/covid-19-eviction-information#cdc-moratorium-information-and-form The Courts’ Standing Orders require that any case filing on or after January 25, 2021 must be accompanied by an affidavit swearing that this attestation form has been given to the tenant. Complete the CDC passenger attestation form at home or during check-in at the airport. Links with this icon indicate that you are leaving the CDC website.. 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