Get Environmental Sample Submission Form - Usf Health

This guide provides comprehensive instructions on filling out the Environmental Sample Submission Form specific to USF Health. It is designed to assist users in accurately completing the form, ensuring all necessary information is included for submission.

Follow the steps to complete the submission form accurately.

1. Click ‘Get Form’ to obtain the form and open it in the designated online editor.
2. Input the case/alarm number in the provided field to identify your submission effectively.
3. Fill in the Lab Sample ID Number to assign a unique identifier to your sample for tracking purposes.
4. Indicate the county where the sample was collected by selecting from the drop-down menu or typing it in.
5. Provide the DASH number if applicable; otherwise, leave it blank.
6. Enter the collection date and time accurately to document when the sample was taken.
7. Input the incident address to specify the location related to the sample submitted.
8. If applicable, enter the targeted individual's name to clarify to whom the sample is associated.
9. Select the appropriate sample description, checking one of the available options such as Bulk powder, Letter/envelope, or Swab.
10. Indicate whether the letter/package was opened, using the yes/no buttons provided.
11. Complete the point of contact (POC) information for the agency collecting the sample, including the agency name, contact name, and phone number.
12. Fill in the point of contact information for the agency transporting the sample, mirroring the previous step.
13. Confirm that field hazard screens have been performed by providing the screening results and tests used for explosives, chemical hazards, and radiological hazards.
14. Assess and denote whether there are any credible threat criteria by selecting yes or no for each listed item as relevant.
15. Provide any additional details related to the credible threat assessments that apply.
16. Indicate whether the building was evacuated and/or closed by selecting the appropriate options.
17. Document the notifications made by including names and dates/times of the individuals who informed relevant parties, such as the BT Coordinator or County/City Warning Point.
18. Complete the results notification section with information for the individual responsible for disseminating results, including all contact details.
19. Sign and date the form to certify the accuracy of the information provided and the timely delivery of the sample.
20. Review all entries to ensure they are complete and accurate before finalizing the submission.
21. Once completed, save the changes, download, or print the form as necessary for your records, and prepare for submission.

Ensure accurate submission of your Environmental Sample Submission Form online for prompt processing.