I understand that:
1. I will comply with Coast Guard and local/state policy: Welcome to the CG-BSX Web Site (uscgaux.info)
2. I will follow CDC Guidelines if ever exposed to COVID-19 or tested positive for COVID-19 prior to being/requesting ATD: COVID-19 Quarantine and Isolation CDC and What to Do If You Are Sick LCDC
3.An Order Issuing Authority (OIA) will use the information provided by me to determine my suitability for assignment to duty.
4. The OIA may require additional information to properly assess my suitability for assignment to duty.
5. Providing information that is not accurate or not true may result in disciplinary action.
6.Not providing this information will result in the presumption that an Auxiliarist is not vaccinated against COVID-19.
Disclaimer: Members are reminded to submit a new form only if any of this information changes.