Chapter 6 – Adult Classification

61010.11 Instructions for Completing the CDC Form 839

• The CDC Form 839 shall be written on a hard surface with ballpoint black ink pen only. Do not use pencil or felt, fiber, or other soft tip pens. This is required so that the printing will come through clearly on the self-carbonized copies. The Information Quality Support Section cannot accept items, which have been erased or marked over to correct because the copies will not be legible. Destroying the erroneous form and completing a new CDC Form 839 shall correct errors detected before copies are distributed.

• Key data entry operators read only those letters and numbers which are inside the boxes on the form. Therefore, underlining and notations in the margins are permitted. Do not write more than one letter or number in each box.

• Right Hand Justified

  • Numbers are to be right-hand justified; that is, end in the box furthest to the right with any empty boxes on the left. The most common problem is zeros that look like sixes, and vice versa, so take special care making these two numbers.

  • Except as noted in these instructions, any unused letter or number item is simply to be left blank.

  • On the CDC Form 839 box numbers appear to the right, but refer to the first box on the left of each field.