Below are the pertinent forms for both beginning and closing out your assignment with CDC. Please note that CDC must receive all of these forms prior to processing your final per diem check. Forms should either be mailed to CDC/Washington or, preferably, sent by email to the appropriate Program Manager.
Should you have any questions please contact the Program Manager for your project.
Forms to complete before assignment
- CDC Medical Release Form. Must be filled out by a physician prior to your departure.
- Emergency Medical and Contact Form. This form must include contact information for at least two individuals at separate locations that can be contacted in the unlikely event of an emergency.
- Media Questionnaire. Please list any local media outlets or trade publications that would be interested in hearing about your experiences with CDC.
Forms to complete after service
- Final Report Template. Volunteers should complete this report at the end of their assignments. Please consider the template a guideline in documenting not only your work while on site but also the suggestions and interventions you recommended to the client for improving their operations.
- Assignment Assessment. In order to continue to provide quality assistance to both our clients and our volunteers, please accurately and honestly complete this form and send it with your final materials.
- Expense Guidelines. Allowable expenses per CDC regulations
- Expense Report Guidelines. Instructions for completing your Expense Report.
- Expense Report. Please submit your boarding passes as well as all relevant receipts along with your Expense Report. Receipts should be stapled single-sided to plain, white paper and clearly labeled. Form
- In-Kind Contribution Form. List hours worked at rate charged and send along with expense report.