MODEL AQUATIC HEALTH CODE CHANGE REQUEST FORM All change requests and supporting materials must be received by February 19, 2015 Please follow the instructions below to request changes to the Model Aquatic Health Code (MAHC). Guidance for Submitting a Change Request Intent: Any interested person or group may submit a change request or multiple requests. Change Requests: Change requests must be completed in accordance with the directions outlined on this form and based on the latest edition of the Model Aquatic Health Code which is published on CDC’s website: http://www.cdc.gov/healthywater/swimming/pools/ma hc/structure-content/. Collective Request: If submitting a change request on behalf of a group or organization, indicate the point of contact in the “Name” line and the group in the “Submitted on Behalf of” line. Form and Content of Change Requests: Please use a separate form for each change request. Submit completed form as a document (“.DOC” or “.DOCX”) attachment to an e-mail. Attach supporting information as PDF or DOC/DOCX attachments to the same e-mail as the associated change request form. Please send only one change request form with supporting information per e-mail. Where to Send Change Requests: Send completed change requests and substantiating resources to: info@cmahc.org. If e-mail is not available, mail disk containing form and supporting materials to: CMAHC CHANGE REQUESTS, P.O. Box 3121, Decatur, Georgia, 30031. Withdrawal of a Proposal or Comment: Withdraw a change request at any time prior to the announced closing date for receiving the change request by sending an e-mail stating so to info@cmahc.org. Guidance for Completing Change Request Form Propose NEW or REVISED or DELETED Text: Present the text of the change request in proper code format and terminology with the specific wording desired, including deletions and additions, shown as indicated on the form. Ensure the request is complete and specific to eliminate misinterpretation. Provide the Reason and Benefit of the Suggested Change: Justify why the requested change is necessary to improve the current provisions of the MAHC. If requesting to add or delete a requirement then support the request with a clear explanation that: 1) Demonstrates why the current provisions are inadequate, and 2) Explains how the change request will improve the MAHC. Substantiate Request with Supporting Information: Substantiate the proposed change based on technical information, published scientific studies, other references or editorial in nature. The responsibility of providing supporting material lies with the submitter of the change request. List all references used within the substantiation section of the change request form by first author and article title. Attach PDF or DOC/DOCX copies of the references cited to the change request e-mail. MODEL AQUATIC HEALTH CODE CHANGE REQUEST FORM Please type or print clearly. Forms containing illegible text cannot be processed. Name: Click here to enter text. Organization: Click here to enter text. Submitted on Behalf of: Click here to enter text. Address: State or Province: Phone: E-mail: City: Click here to enter text. Click here to enter text. Click here to enter text. Date: Click here to enter text. Zip or Mail Code: Ext: Click here to enter a date. Click here to enter text. Click here to enter text. Country: Click here to enter text. Click here to enter text. Fax: Click here to enter text. Click here to enter text. 1) Specify the MAHC Section, Table, or Figure of this Change Request Check the box to indicate proposed changed of MAHC Section, Table, or Figure. Type the specific MAHC provision number beside “Number” (e.g., “5.7.4.4.1”). ☐ Section ☐ Table ☐ Figure 2) Note Other MAHC Sections Affected by this Change: Number: Click here to enter text. Click here to enter text. 3) Select How MAHC Section Should Change Check the applicable box. ☐ Revise as follows ☐ Add new text as follows ☐ Delete and substitute as follows ☐ Delete without Substitution 4) Propose NEW or REVISED or DELETED Text Strikethrough text to be deleted. Underline text to be added. Remember: Only one change request per form. Click here to enter text. 5) Provide the Reason and Benefit of Suggested Change (e.g., cost reduction, public health impact, new technology, etc.) Click here to enter text. 6) Substantiate Request with Supporting Information Provide substantiation to support proposed change. Changes must be supported by technical information, published scientific studies, other references, or editorial in nature. Below, please cite references by name of first author and article title. (e.g., Author, Title.) Click here to enter text.