- Non-Registered Facility Report for Suspected SSBAs and Comfirmatory Testing Results (PDF 309 KB)
- Non-Registered Facility Report for Suspected SSBAs and Comfirmatory Testing Results (Word 206 KB)
Release Date: July 2019
Please complete this form if you are Not Registered to handle SSBAs and:
- you transfer a suspected SSBA for confirmatory testing; or
- you destroy a suspected SSBA prior to confirmatory testing; or
- you performed your own confirmatory testing on a suspected SSBA and are reporting the results of the test; or
- you sent a suspected SSBA to another facility for confirmatory testing and you are reporting the results of the test.
Please note: If your facility has received a known1 SSBA please complete a Non Registered Facility Report - Temporary Handling or Disposal of an SSBA.
If, on the basis of your facility’s normal testing procedures, you form a reasonable suspicion2 that you are handling an SSBA, you must arrange for confirmatory testing or destroy the suspected SSBA as soon as possible and within two business days after forming your suspicion. If the confirmatory testing is to take place at another facility, you must also report the transfer of the suspected SSBA to the confirmatory testing facility.
If you arranged for confirmatory testing of the SSBA, either by your facility or by another facility, you must report the results of the confirmatory test as soon as possible and within two business days after receiving the results.
If the suspected SSBA is confirmed you must decide to either register to handle the SSBA or transfer or destroy the entire holdings of the SSBA. Registration or transfer/destruction must take place within two business days of receipt of the positive confirmatory test result unless an extension of time is permitted – refer to Retention Requirements below.
Suspected SSBAs and SSBAs confirmed by confirmatory testing must be handled according to the requirements of Parts 9 and 9A of the SSBA Standards.
You must complete a separate form each time the facility handles a suspected SSBA.top of page
If you intend to dispose3 of the SSBA once confirmatory testing is completed and there are requirements for you to retain the confirmed SSBA for longer than two business days (for example due to requirements under the National Pathology Accreditation Advisory Council (NPAAC) guideline on Requirements for the Retention of Laboratory Records and Diagnostic Materials), you must:
- report the positive confirmatory result to Health within two business days of receipt of the results; and
- request a extension to the prescribed handling period prior to disposal.
To apply for an extension, please complete the Application for Extension section of this form. If this request is granted your time period for handling will be extended and following the end of this period you will be required to dispose of the SSBA and must report the disposal to Health within two business days of the disposal occuring.
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.
Please ensure that the person completing this form holds the appropriate authority to submit this application on behalf of the entity or facility. For non-registered facilities the person authorised to make this report may be a person who senior management determines has responsibility for overseeing work related to SSBA material, eg Laboratory Managers.
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 marked with an * are mandatory and must be completed. Other fields are to be completed only if the information has changed. 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.top of page
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:
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 by email to the contact officer listed for the facility.
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
- A known SSBA for the purposes of temporary handling requirements is one that was confirmed by laboratory testing before being transferred into your facility.
- Reasonable suspicion does not apply just because an SSBA is not yet ruled out but rather, on the balance of probabilities, the agent is likely to be an SSBA.
- 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).