SSBA Reporting Forms: Registered Facility Report for Suspected SSBAs and Confirmatory Testing Results

Use this form if you are Registered to handle SSBAs and you:

Page last updated: 15 August 2019

SSBA Reporting Forms List

Release Date: July 2019

Please complete this form if you are Registered to handle SSBAs and receive a suspected SSBA for which you are not registered and you:

  • transfer the suspected SSBA for confirmatory testing; or
  • destroy the suspected SSBA prior to confirmatory testing; or
  • performed your own confirmatory testing on the suspected SSBA and are reporting the results of the test; or
  • sent the 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 for which you are not registered please complete a Registered Facility Report - Temporary Handling or Disposal of an SSBA. If you intend to retain the SSBA you must fill in a Start to Handle a new SSBA form.

Introduction

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 – see 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.

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Retention Requirements

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.

Privacy

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 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.

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Lodgement

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 andLaboratories 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.

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 for the purposes of temporary handling requirements is one that was confirmed by laboratory testing before being transferred into your facility.
  2. 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.
  3. Disposal is the complete transfer or destruction of the SSBA.

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(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).