CMAHC Technical Review Committee (TRC)Change Request Evaluation Form
CR #:Click here to enter text./ MAHC Section #: Click here to enter text.
MAHC Code page #: Click here to enter text.
MAHC Annex Page #:Click here to enter text.
Submitter Name, Organization/ Click here to enter text. /
TRC CR Champion/ Click here to enter text. /
CR Type/ ☐Clarification/Edit ☐ Updated Information
☐ Move Section ☐Add/Delete Section ☐ New Section
Document Posted for Voting/ ☐ Posted as Submitted
☐ Posted as Submitted, TRC Modifications Not Acceptable to Submitter
☐ Posted with Approved TRC/Submitter Modifications
☐ Posted with TRC Modification; Submitter did not respond within required timeframe (sent 1 email/week for 3 weeks)
TRC Recommendation/ ☐ Yes Vote ☐ No Vote ☐ Abstain
Reasons forNo Vote or Abstaining TRC Recommendation(Check all that apply) / ☐Incomplete ☐Revolution not Evolution ☐Prohibitive Cost Impact
☐Additional Research/Improvement Needed
☐Negative Health Impact ☐ TRC Unable to Reach Consensus
Explanatory Notes (If any)/ Click here to enter text. /
Change Request (CR) Review Criteria☐ / ☐ / Is this CR complete?
☐ / ☐ / Is the CR editorial?
☐ / ☐ / If above question is “Yes,” does it improve the clarity and interpretation of the MAHC?
☐ / ☐ / Does it follow the CDC style sheet?
☐ / ☐ / Is the CR science-based?
☐ / ☐ / Is the CR best practice-based?
☐ / ☐ / Does the CR need to be improved to be accepted?
☐ / ☐ / Can the CR be easily improved by the TRC?
Supporting Documentation☐ / ☐ / Is supporting documentation (peer-reviewed, scientific rationale and/or data) provided to support CR?
☐ / ☐ / Has supporting documentation been evaluated/reviewed?
☐ / ☐ / Does the documentation support the CR?
☐ / ☐ / Is the supporting documentation scientifically reputable and sound?
☐ / ☐ / Has the CR been proposed/addressed previously (i.e., submitted during individual module public comment or knitted version public comment), or as a 2015 CR?
☐ / ☐ / If yes, does CR provide additional/or different supporting documentation than previous public comment?
Impact of Change☐ / ☐ / Will the change increase cost of construction or operation? Please quantify in notes.
☐ / ☐ / Is there a positive public health impact?
☐ / ☐ / Is there a negative public health impact?
☐ / ☐ / Does this change request demonstrate "evolution" rather than "revolution"?
CR SUMMARY REPORT
CR #:/ Click here to enter text. /
Suggested MAHCChange(s):/ Click here to enter text. /
Does TRC RecommendCode/Annex Language Different from Original CR Submission?/ ☐Yes
If Yes, Are Changes Approved by Submitting Author?/ ☐Yes
If Yes, TRCRecommended MAHC Language:/ Click here to enter text. /
Review Process and Rationale
(include ALL TRC viewpoints if consensus was not reached)
TSC Consulted?/ ☐ Yes
☐ No If Yes, TSC Name? Click here to enter text.
Summary of Internal TRC and TSC (if used) Discussion:/ Click here to enter text. /
Summary of CMAHC Member Comments:/ Click here to enter text. /
Summary of the Pros/Cons and/or Benefits/Deficits of the CR and the Thought Process of the TRC Review of the CR:/ Click here to enter text. /
TRC Recommendationto Board of Directors:/ Click here to enter text. /
Recommended Future Action:/ Click here to enter text. /