Attachment 13 509 MDG Public Health Travel Risk Assessment Form.pdf

DEPARTMENT OF THE AIR FORCE

509TH OPERATIONAL MEDICAL READINESS SQUADRON (AFGSC)

WHITEMAN AIR FORCE BASE, MISSOURI

WITHOUT MED OPS…THE MISSION STOPS!

509TH MDG PUBLIC HEALH COVID-19 PRE/POST TRAVEL RISK ASSESSMENT AND

GUIDANCE

Date:

Contact Phone #:

Full Name:

Departure Location/Date:

Arrival Location/Date:

Number/Locations of Stops along Travel:

Travel Risk Assessment (Public Health Use):

Public Health Recommendation (Public Health Use):

Attachment 13

Travel Guidance pre/post:

• Clean your hands often.

• Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.

• If soap and water are not readily available, use a hand sanitizer that contains at least 60%alcohol. Cover all surfaces of your hands and rub your hands together until they feel dry.

• Avoid touching your eyes, nose, and mouth.

• Avoid close contact with others.

• Keep 6 feet of physical distance from others.

• Avoiding close contact is especially important if you are at higher risk of getting very sick from

COVID-19.

• Wear a cloth face covering in public.

• Cover coughs and sneezes.

• Pick up food at drive-throughs, curbside restaurant service, or stores. Do not dine in restaurants if that is prohibited by state or local guidance.

Member/Sponsor Signature Public Health

If at any point during travel you are feeling sick please contact Whiteman AFB Public Health (660-687-4305) or go to the nearest Urgent Care or Emergency Room.