Sailing Contact Form

Analysis of and Participation in Ocean Exploration Video Products

Sailing Contact Form_Revised

OMB: 0648-0748

Document [pdf]
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10/6/23, 11:27 AM

Sailing Contact Form

Sailing Contact Form
Field Season 2023
* Indicates required question

1.

Email *

Purpose Statement
This form is to be filled out by all mission personnel sailing on any expedition coordinated by a
member of NOAA Ocean Exploration. The answers provided to the form questions are intended to
provide all requisite parties with the required information to successfully plan and execute an
expedition. By filling out this form 30 days prior to sailing, the expedition coordinator and
respective ship operations officer will be given appropriate time to plan for the personnel details
collected by this form in a respective summary sheet. If you have any questions or comments on
any part of this form, please reach out to your expedition coordinator (EC).

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Sailing Contact Form

Paperwork Reduction Act Statement
OMB Control Number 0648-0748  Expiration date: 12/31/2023
Paperwork Reduction Act Statement
PRA Burden Reporting: Public reporting burden for this collection of information is estimated to
average 10 minutes per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other
suggestions for reducing this burden to Abby Letts, Office of Ocean Exploration and Research,
abby.letts@noaa.gov
Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any
person be subjected to a penalty for failure to comply with, a collection of information subject to
the requirements of the Paperwork Reduction Act, unless that collection of information displays a
currently valid OMB Control Number.
Authority: The collection of this information is authorized under 5 U.S.C. § 301, Departmental
regulations; Executive Order 12656, Assignment of emergency preparedness responsibilities;
Homeland Security, Federal Continuity Directive 1, requiring Federal agencies to account for its
personnel during emergencies; and Departmental Administrative Order 210-1, Emergency
Readiness for Departmental Continuity.
Purpose: The Department of Commerce (Department) is collecting this information to ensure
managers, supervisors, continuity of operations (COOP), and other appropriate staff and
individuals have the most current personal contact information for contacting you in the event of
an emergency or planned exercise. As an example, the information will be used to ensure
employee accountability as it relates to protection and safe being in a catastrophic situation.
Routine Uses: The Department will use this information to send notifications, alerts, and/or
activations and to relay critical updates and guidance to Department personnel in response to an
emergency scenario or exercise. Disclosure of this information is permitted under the Privacy Act
of 1974 (5 U.S.C. Section 552a) to be shared among Department staff for work-related purposes.
Disclosure of this information is also subject to all of the published routine uses as identified in
the Privacy Act System of Records Notice COMMERCE/DEPT-18, Employees Personnel Files Not
Covered by Notices of Other Agencies.
Disclosure: Furnishing this information is mandatory. The failure to provide accurate information
may delay or prevent you from receiving notifications in the event of an emergency. The failure to
provide this information also may have an effect on your Federal service under certain
circumstances. For example, failure to supply this information may delay or make it impossible to
notify you in the event of an emergency about a change to your duty location and/or the
Department’s needs for your service in an emergency, which may result in you being placed in an
absent without leave status.

Multiple Expeditions

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Sailing Contact Form

Read below if you may sail more than once this year
You can fill out this form once for an entire year and fill out the estimated travel dates for future
expeditions. This will save you time from clicking through repetitive questions each expedition,
BUT you must update your travel dates. After submitting this form, you will be sent an email that
allows you to update any answer in this form. PLEASE SAVE THAT EMAIL.

Your 1st Expedition
This is your first expedition for this form. You can can fill out multiple expeditions if you want
to save time.

2.

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

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3.

Sailing Contact Form

Role During the Selected Expedition or Mission *
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

4.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already be
aboard from a previous expedition?

Mark only one oval.
Yes
No

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5.

Sailing Contact Form

Arrival Date *

Example: January 7, 2019

6.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

7.

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when do
you move off ship. If you will stay aboard for multiple expeditions, please put your date of
FINAL departure from the ship.

Example: January 7, 2019

8.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable link
to modify your answers at a later time. If you generally know the dates of travel, but are just
waiting for the ship schedule to be finalized to purchase your tickets, you can select "yes".
You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 2nd Expedition

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9.

Sailing Contact Form

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

10.

Role During the Selected Expedition or Mission
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

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Sailing Contact Form

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

11.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

12.

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

13.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

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14.

Sailing Contact Form

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

15.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 3rd Expedition

16.

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

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17.

Sailing Contact Form

Role During the Selected Expedition or Mission
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

18.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

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19.

Sailing Contact Form

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

20.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

21.

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

22.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 4th Expedition

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23.

Sailing Contact Form

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

24.

Role During the Selected Cruise or Expedition
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

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Sailing Contact Form

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

25.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

26.

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

27.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

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28.

Sailing Contact Form

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

29.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 5th Expedition

30.

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

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31.

Sailing Contact Form

Role During the Selected Expedition or Mission
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

32.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

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33.

Sailing Contact Form

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

34.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

35.

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

36.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 6th Expedition

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37.

Sailing Contact Form

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

38.

Role During the Selected Expedition or Mission
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

https://docs.google.com/forms/d/1Grc_AuGGfQYvMdnd42w1-JTuehxfb8pPS0LWhMHaawk/edit?pli=1

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Sailing Contact Form

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

39.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

40.

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

41.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

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42.

Sailing Contact Form

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

43.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 7th Expedition

44.

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

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45.

Sailing Contact Form

Role During the Selected Expedition or Mission
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

46.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

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47.

Sailing Contact Form

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

48.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

49.

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

50.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Your 8th Expedition

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51.

Sailing Contact Form

Expedition ID *
Mark only one oval.
EX2301
EX2302
EX2303
EX2304
EX2305
EX2306
EX2307
EX2308
EX2309
EX2310

52.

Role During the Selected Expedition or Mission
Mark only one oval.
Expedition Coordinator
Mapping Watch Stander
Explorer in Training
Training Expedition Coordinator
Science Lead
GFOE Lead
GFOE Personnel
Sample Data Manager
Guest Scientist
Teacher at Sea
Other:

https://docs.google.com/forms/d/1Grc_AuGGfQYvMdnd42w1-JTuehxfb8pPS0LWhMHaawk/edit?pli=1

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Sailing Contact Form

Arrival and Departure Instructions
PLEASE READ
Your planned arrival and departure dates are required by NOAA Ocean Exploration and the ship.
Your planned dates may change, but you must inform your expedition coordinator of any change.
Specific dates as it relates to expeditions (such as sail dates or move aboard dates) shall be
confirmed by your expedition coordinator. Do not guess. If unsure, please ask.

53.

Starting Aboard *
At the commencement of the expedition you are completing this form for, will you already
be aboard from a previous expedition?

Mark only one oval.
Yes
No

54.

Arrival Date *
If you will be aboard from a previous expedition, please put your FIRST arrival date.

Example: January 7, 2019

55.

Staying Aboard *
At the conclusion of the expedition you are completing this form for, will you be staying
aboard for another expedition?

Mark only one oval.
Yes
No

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56.

Sailing Contact Form

Departure Date *
When do you plan on departing the ship? Not necessarily when you travel home, but when
do you move off ship. If you will stay aboard for multiple expeditions, please put your date
of FINAL departure from the ship.

Example: January 7, 2019

57.

Fill out Dates for Another Expedition/Mission? *
If not sailing on another expedition or if you do not yet know the dates of travel for your
additional expedition(s), select "no" at this time, and you will be provided with an editable
link to modify your answers at a later time. If you generally know the dates of travel, but are
just waiting for the ship schedule to be finalized to purchase your tickets, you can select
"yes". You will need to notify the expedition coordinator of any changes to your plans ASAP.

Mark only one oval.
Yes
No

Skip to question 58

Personal Information

58.

First Name *

59.

Last Name *

60.

Middle Initial
(optional)

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Sailing Contact Form

61.

Affiliation *

62.

Cell Phone *
Your cell phone number will not be shared outside of need to know operational personnel.
Your cell phone number may be necessary during emergencies and will only be used for as
needed operations.

63.

Physical Address
Make sure to include street, city, state, zip and if applicable apartment number.

64.

Dietary Restrictions *
Such as "none", "vegan", "no gluten", etc. Used by the ship stewards to create meal plans.

65.

Room Assignment *
Information on gender is used to determine one's roommate assignment aboard the ship. If
you identify as non-binary, please select the room accommodation you would be most
comfortable with.

Mark only one oval.
Male
Female

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66.

Sailing Contact Form

TWIC *
Do you have an active Transportation Worker Identification Credential, also known as
TWIC?

Mark only one oval.
Yes
No

67.

CAC *
Do you have an active Common Access Card, also known as a CAC?

Mark only one oval.
Yes
No

International or Domestic

68.

International Expedition?
If at least 1 of your ports may be international (outside US) or you may be transiting
through another country's water (such as the Canadian/Alaskan Inside Passage), please
select "Yes" so you can add your passport information. If you are unsure ask the expedition
coordinator.

Mark only one oval.
Yes
No

Skip to question 70
Skip to question 69

Citizenship

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69.

Sailing Contact Form

USA Citizen *
Are you a citizen of the United States of America?

Mark only one oval.
Yes, USA
No

Skip to question 75

Skip to question 70

Skip to question 75

Passport Information
You have been directed here either because you have indicated one of your cruises may be
international or you are not a US citizen. It is critical that you have a passport for this cruise. If
you do not, you may not be able to sail.

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70.

Sailing Contact Form

Do you have a Passport? *
If "No", please notify your expedition coordinator immediately.

Mark only one oval.
Yes
No

71.

Skip to question 75
Skip to section 15 (No Passport Warning)

Citizenship *
Type country if not USA

Mark only one oval.
USA
Other:

72.

Passport Issuing Country *
Example: USA, Canada, Japan, etc

Mark only one oval.
I do not have a passport and understand that I must notify my expedition
coordinator
USA
Other:

73.

Passport Number *
Mark only one oval.
I do not have a passport and understand that I must notify my expedition
coordinator
Other:

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74.

Sailing Contact Form

Passport Expiration Date *
Mark only one oval.
I do not have a passport and understand that I must notify my expedition
coordinator
Other:

No Passport Warning
You have been flagged as potentially unable to sail for NOAA Ocean Exploration expeditions.
Please discuss with your expedition coordinator(s) to understand the exact requirements for
your expedition(s) and if it may be possible to acquire a passport in time.

Emergency Contact Information

75.

First Name (Emergency Contact) *

76.

Last Name *

77.

Middle Initial
(Optional)

78.

Relationship *

79.

Phone Number *

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80.

Sailing Contact Form

Physical Address *
Make sure to include Zip and if applicable apartment #

Mark only one oval.
Same Address in Personal Contact
Other:

81.

Email *

Medical

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Sailing Contact Form

Instructions
You must --securely-- submit to MOC-A Health Services 30 days prior to sailing
  -  Completed NOAA Health Service Questionnaire (NHSQ),
  -  Completed Tuberculosis Screening Document (TB/PPD document).
*New as of 2022, yearly Tuberculosis Skin Testing or Blood Tests are not required (unless
clinically indicated) and are now replaced with a new 57-10-02 Tuberculosis Screening Form. The
questions on the 57-10-02 could clinically indicate the need for a TB test (but this should be far
and few between). Please fill out Section A, sign, and submit to OMAO. OMAO will complete the
"Provider's Recommendation" and will follow up if subsequent TB testing is required. *
Tuberculosis Screening Document is valid for 1 year. NHSQ is valid for 1 year for those 50 years+
and 2 years for those younger than 50 years. Full COVID-19 Vaccination (fully vaccinated = initial
round of vaccines and at least one booster) has been required to sail since 2022. If you have
questions about this requirement, please use the general contact below.
Health Services will review and decide whether to clear you to sail. If unsure if your clearance
from a previous cruise is current, please call or email Health Services (can also resubmit).
SECURE CONTACT
If you HAVE a NOAA email, you can use Kiteworks to transmit these files to the email below.
Kiteworks: https://sfc.doc.gov/     (can request new password)
If you do NOT HAVE a NOAA email, please fax or mail your forms to MOC-A Health Services.
Fax: (757) 441-3760
Address: MOA Marine Health Services 439 W. York St., Norfolk, VA 23510
GENERAL CONTACT
Phone: (757) 441-6320
Email: moa.health.services@noaa.gov
More Information: https://www.omao.noaa.gov/learn/headquarters/office-healthservices/marine-medicine/scientists-and-contractors

82.

Submitted NHSQ *
https://www.omao.noaa.gov/sites/default/files/documents/NOAA%20Form%2057-1001%20%2803-16%29%20Health%20Services%20Questionnaire.pdf

Mark only one oval.
Yes
No

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83.

Sailing Contact Form

Submitted TB/PPD

*

https://www.omao.noaa.gov/sites/default/files/2023-01/NOAA%20Form%205710-02%20OMAO%20Annual%20Tuberculosis%20Screening.pdf
Mark only one oval.
Yes
No

Medical Cont. (COVID)
To sail on NOAA Ship Okeanos Explorer as part of NOAA Ocean Exploration expeditions, you
must read and understand the following material and policies listed below as well as agree to
comply with any provisions, stipulations, and consequences outlined therein. Failure to
accept and comply with such provisions and stipulations as written will be cause for the
responsible authority to take appropriate actions as to insure the safety of the other sailing
personnel. Such corrective actions taken in response to non-compliance can include
removing the privilege to sail aboard an expedition.
If you are unable to access any linked document or folder listed in this Google Form or if you
have any questions on any provided material, please contact your expedition coordinator to
ensure you are given appropriate access to read all necessary material or to ensure any of
your questions on the material are fully addressed. If you are unable to reach your expedition
coordinator, you may send an email to ex.expeditioncoordinator@noaa.gov to request further
assistance.

COVID-19 Required Material and Policies
You are expected to read this document in it's entirety. If you don't have access, contact your
expedition coordinator.
https://drive.google.com/file/d/12WsVIoFky4OskV4ZbBpDXd9W8OU_y6rz/view
Notable updates in the March 2023 guidance:
1. Removes the COVID-19 booster requirement for clearance to sail.
2. Clarifies the ability to remain underway with a COVID positive case.
3. Removes the option for ON/OFF toggles for surveillance testing and pre-live aboard testing.
4. Adds the option for ON/OFF toggles for pre-sail testing requirements.
5. Updates CDC guidance for coming out of isolation.
COVID-19 guidance is always evolving. Check in with the expedition coordinator to get the latest
guidance prior to sailing.

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Sailing Contact Form

COVID Testing
The need for pre-sail COVID testing will be determined on a month-by-month basis by the Director,
Marine Medical Branch. When testing is required, personnel must test using a rapid antigen test
conducted or observed by a Medical Officer, MPIC, or other trained testing observer the day of or
night before sailing. Anyone who tests positive for COVID-19 is not cleared to sail. If your test
results are inconclusive/indeterminate, you are not cleared to sail, but you may attempt additional
rapid molecular tests to obtain a definitive result.
Testing guidance is always evolving. Check in with the expedition coordinator to get the latest
guidance prior to sailing.
For those interested in additional resources, the below link can be used to receive 4 free Rapid
Tests mailed to your home:
https://www.covidtests.gov/

84.

Required COVID-19 Reading *
You must have read all materials and policies listed above in order to submit this sailing
contact form.

Mark only one oval.
I have read and understood all materials and policy.

85.

Agree to uphold NOAA COVID-19 Requirements, Guidelines, and Expectations? *
After reading all materials and policies linked in this form, you must indicate your
agreement or otherwise with any provisions, stipulations, and consequences outlined
therein and understand that agreement is required to sail. Non-compliance with any such
provisions and stipulations will be reported to the Expedition Coordinator, Commanding
Officer, and/or NOAA Ocean Exploration Operations Chief and can be cause for the
responsible authority to take appropriate actions.

Mark only one oval.
Yes, I agree
No, I do NOT agree

Skip to question 84

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86.

Sailing Contact Form

Submitted COVID-19 Vaccine Record *
VERY IMPORTANT: You will NOT sail if you fail to do this. Submit this WITH your NHSQ.
Please note that the requirement for COVID 19 boosters has been removed.

Mark only one oval.
Yes
No

NOAA Sexual Assault and Sexual Harassment Prevention and Response Policy
NOAA Ocean Exploration is committed to providing a workplace free of sexual harassment
and sexual assault (SASH) including while traveling for work and sailing aboard expeditions.
The following NOAA policy provides definitions, reporting directions, resources for victims,
and other helpful guidance. If you have any questions about this policy or how things are
handled onboard, please discuss with your Expedition Coordinator or any NOAA Ocean
Exploration supervisor. You are required to confirm you have read and understood the policy.

Reporting POCs and Additional Guidance
Please download and read the full NOAA Ocean Exploration SASH guidance linked below which
provides guidance and critical information on SASH for seagoing personnel.
This document includes appropriate contact information for reporting an incident, methods to
contact the SASH helpline, and answers to questions of anonymity. NOAA Ocean Exploration
highly recommends you print a copy and keep it on your person during your travels.
A brief takeaway is that incidents can be reported to the ship CO or XO, any NOAA or DOC
supervisor, NOAA's Workplace Violence Prevention and Response (WVPR) regional coordinators,
a WVPR Volunteer Advocate Liaison, a Line Office EEO and Diversity Program Manager, or a
Regional or Marine and Aviation Center Sexual Harassment/EEO Collateral Duty Specialist. 
**Please note that ship command, supervisors, and EEO personnel are mandatory reporters. If
you would like to make a restricted report (i.e. a report that does not initiate an investigation into
the allegations or require the release of information to supervisors, managers, investigators, etc.)
you can make a report to the following sources: NOAA's Workplace Violence Prevention Response
(WVPR)'s Regional Coordinators and WVPRs Volunteer Assistance Liaisons.**

NOAA Ocean Exploration SASH Guidance
https://drive.google.com/file/d/1FRcQ0VXfGOHSqzc_2ewkMTCTgku6B5dk/view?usp=sharing

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Sailing Contact Form

NOAA SASH Policy
https://www.noaa.gov/organization/administration/nao-202-1106-noaa-sexual-assault-andsexual-harassment-prevention-and

87.

Have you read and understood the NOAA SASH Policy above? *
Mark only one oval.
Yes, I have read and understood current NOAA SASH Policy
No, I have not read the policy

Skip to question 89

Skip to question 87

I have comments, questions, or concerns
Skip to section 20 (Please Speak to an NOAA Ocean Exploration Contact Listed)

OMAO SASH Training Requirement
Per the Office of Marine and Aviation Operations, NOAA vessels shall ensure their sailing
personnel have also been provided with the necessary SASH training, orientations, and videos as
appropriate. For example, sailing on NOAA Ship Okeanos Explorer (EX) requires mission
personnel to have watched an OMAO SASH training video typically as part of an on board
orientation at least once a field season. You will be asked if you have already completed this
OMAO SASH orientation below. This is useful information for OMAO Operation Officers because
your response allows them to plan for how many need to watch the SASH video.

88.

Completed OMAO SASH Orientation This Field Season? *
If this is your first expedition this season aboard an OMAO vessel (such as EX) then your
response should be "no".

Mark only one oval.
No
Yes
N/A (I am not sailing aboard an OMAO vessel)

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Please Speak to an NOAA Ocean Exploration Contact Listed
NOAA Ocean Exploration is committed to providing high standards for the prevention,
response, and guiding principles as it pertains to sexual assault and harassment. Our office
takes your concerns very seriously. Please discuss your questions, comments, or concerns
with your expedition coordinator before continuing to fill out this form.
If you do not feel comfortable discussing with your expedition coordinator, please contact the
E&E Operations Chief for further assistance: kasey.cantwell@noaa.gov. Kasey will be
available to discuss the SASH policies cited in this form or put you in contact with a more
appropriate person. Please note that while Kasey can answer general policy questions, she is
a mandatory reporter for reports of SASH incidents. 
Skip to question 87

Non Disclosure Agreement for Underwater Cultural Heritage Sites
Although NOAA Ocean Exploration conducts non-disturbance underwater cultural heritage
(UCH) exploration activities, project data and information may contain site location
information that could lead to adverse impacts if disclosed.
Since all expedition participants will have access to position/location information about
historically significant or potentially historically significant UCH sites, we must require you to
read and agree to the terms of the attached non-disclosure agreement (NDA) before we can
allow your participation.

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89.

Sailing Contact Form

Please select the appropriate response concerning the NOAA Ocean Exploration

*

Non-Disclosure Agreement
Mark only one oval.
I agree to the terms and conditions outlined in the non-disclosure agreement
Skip to question 91
I do NOT agree to the terms and conditions outlined in the non-disclosure
agreement
Skip to question 89

Likeness and Profile Release to NOAA
NOAA Ship Okeanos Explorer enables telepresence exploration and broadcasts 24/7
operations to shore. Please review the Likeness and Profile Release to NOAA and email the
signed form to ocean-explore-comms@noaa.gov.   

90.

Please select the appropriate response:
Mark only one oval.
I have submitted the release to ocean-explore-comms@noaa.gov
I do not agree to sign the release and have contacted my expedition coordinator

Thank You!

Please Read
Thank you for reading all material and submitting all of the information as part of this form.
You will be emailed a link back to this form for which you can edit your response such as adding a
cruise or updating travel dates.

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91.

Sailing Contact Form

Acknowledgment *
I acknowledge that it is my responsibility to update my responses such as travel dates and
that if I make any change that I will communicate this change with my expedition
coordinator.

Mark only one oval.
Agree
Disagree

Skip to question 91

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