Get the free select agent survey form - bmc

Page 1 CDC SELECT AGENT SURVEY Principal Investigator/Name Date Department Room Phone Title of Project Please check one of the following I have reviewed the list of select agent microorganisms and toxins and I do not possess or use any of these agents. Select agent viral nucleic acids synthetic or naturally derived contiguous or fragmented in host chromosomes or in expression vectors that have potential to encode infectious and/or replication competent forms of any of the select agent...

How to fill out select agent survey form

How to fill out select agent survey form:

1. Start by carefully reading through the instructions provided with the form. Make sure you understand the purpose of the survey and the information required.
2. Gather all the necessary information and documents before you begin filling out the form. This may include details about the select agents being used, laboratory facilities, personnel involved, and any previous incidents or violations.
3. Begin by providing the requested general information, such as your name, contact information, and the name of the institution or organization you are affiliated with.
4. Follow the instructions to accurately complete each section of the survey form. This may involve providing details about the select agents being used, including their names, classification, and quantities.
5. Provide information about the laboratory facilities, including their location, types of containment, and security measures in place.
6. Indicate the personnel involved in handling the select agents, including their names, qualifications, and training records.
7. If applicable, provide details about any incidents or violations that have occurred in relation to select agent handling or any sanctions imposed on you or your institution.
8. Review the completed form to ensure all required information has been accurately provided and that there are no errors or omissions.
9. Sign and date the form to certify the accuracy and completeness of the information provided.
10. Submit the completed select agent survey form to the designated authority or agency, following any specific submission instructions provided.

Who needs select agent survey form:

1. Research institutions and laboratories that handle select agents or toxins.
2. Health departments or government agencies responsible for regulating the handling and storage of select agents.
3. Any individual or organization involved in activities that fall under the regulations governing select agents and toxins.

For pdfFiller’s FAQs

How do I edit select agent survey form online?

With pdfFiller, you may not only alter the content but also rearrange the pages. Upload your select agent survey form and modify it with a few clicks. The editor lets you add photos, sticky notes, text boxes, and more to PDFs.

How do I edit select agent survey form in Chrome?

Get and add pdfFiller Google Chrome Extension to your browser to edit, fill out and eSign your select agent survey form, which you can open in the editor directly from a Google search page in just one click. Execute your fillable documents from any internet-connected device without leaving Chrome.

How do I fill out the select agent survey form form on my smartphone?

On your mobile device, use the pdfFiller mobile app to complete and sign select agent survey form. Visit our website (https://edit-pdf-ios-android.pdffiller.com/) to discover more about our mobile applications, the features you'll have access to, and how to get started.

What is select agent survey form?

The select agent survey form is a document used to gather information about the select agents and toxins that are possessed, used, or transferred by individuals or entities registered with the Select Agent Program.

Who is required to file select agent survey form?

Any individual or entity registered with the Select Agent Program is required to file the select agent survey form.

How to fill out select agent survey form?

To fill out the select agent survey form, one must provide accurate information about the select agents and toxins in their possession, use, or transfer. The form should be completed online or through the specified submission process provided by the program.

What is the purpose of select agent survey form?

The purpose of the select agent survey form is to gather data on the select agents and toxins being handled by registered individuals or entities. This information helps in assessing risks, monitoring compliance, and ensuring biosecurity.

What information must be reported on select agent survey form?

The select agent survey form requires reporting of details such as the name and description of the select agents and toxins, their quantities, storage locations, modes of use, and transfer activities.