SSBA Reporting Forms: Application for Extension

Use this form to apply for an extension when you are required to handle an SSBA for longer than prescribed timeframes. Please note an extention is not required when waiting for the results of confirmatory testing.

Page last updated: 15 August 2019

SSBA Reporting Forms List

Release Date: July 2019


The National Health Security Act 2007 (NHS Act) mandates that entities handling SSBAs report to the Department of Health (Health).

An entity must only retain and handle an SSBA for which it is not registered for the following prescribed handling periods:

Entities handling a known1 SSBA under the Temporary Handing provisions - 7 working days

Entities handling a previously suspected SSBA that has been confirmed as an SSBA by in-house or external testing - 2 working days

Entities may be required to retain SSBAs for longer than the prescribed handling period, for example, under the National Pathology Accreditation Advisory Council (NPAAC) guideline on Requirements for the Retention of Laboratory Records and Diagnostic Material. If there is a requirement to retain the SSBA for longer than the prescribed handling period, you must request an extension to continue handling the SSBA. If this request is granted you must then dispose2 of the SSBA following the extended handling period and report the disposal to Health within two business days of the disposal occurring, or register to handle the SSBA.

Please do Not complete this form if you waiting for confirmatory testing results for a suspected SSBA. You must notify Health of the transfer of the Suspected SSBA for, and the outcomes of, confirmatory testing using the appropriate Report for Suspected SSBAs and Confirmatory Testing Results.

You must complete a separate form each time you wish to request an extension to the prescribed handling period.

top of page

Providing information to Health

The information you provide to Health is mandated by the National Health Security Act 2007 and will be included on the National Register of SSBAs.

It is important to answer all questions and to provide accurate information. If the information you provide is incorrect or incomplete, Health may require you to provide additional information. This may cause delays.


Personal information provided to Health is handled according to the requirements of the Privacy Act 1988.

Application Authorisation

Please ensure that the person completing this form holds the appropriate authority to submit this application on the behalf of the entity or facility.

Instructions on completing this form

This document allows electronic entry of information into the required fields. It is recommended that, where possible, this form should be completed on a computer and a copy printed, signed and sent to Health.

All questions are mandatory unless otherwise stated and must be completed. If the space provided in each field is not sufficient to complete your answer, please include any additional information in an attachment with the information clearly marked as to which question it relates to.

Please ensure you retain a copy of this completed form as Health is unable to provide copies of submitted documents.


To lodge this form via post you will need to use an opaque envelope and post using Australia Post’s Registered Mail service. You are considered to have submitted the report at the date and time shown on the registered post receipt.

Please do not email or fax forms to Health as these cannot be accepted.

Please submit all postal applications to:

The Director
Health Emergency Planning, Security and Laboratories Section
Department of Health
MDP 140, GPO Box 9848
Canberra ACT 2601

Once Health has received the form, you will be provided with a confirmation of receipt via email to the Responsible Officer or Contact Officer. 

Further Information

Please use your facility reference number to refer to any matters relating to your facility.

If you have any queries about this form please contact the SSBA Regulatory Scheme:

Telephone: (02) 6289 7477
Email: SSBA

  1. A known SSBA is one that has been confirmed as an SSBA prior to being transferred to the reporting facility.
  2. Disposal is the complete transfer or destruction of the SSBA.

(This page contains form/s that are intended to be paper based that you can download and complete. If you are using any assistive technology and are unable to use the form please contact us using the Online form and feedback).