APHIS/CDC Form 4A Quick Reference Guide: Completing Sections A & B

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  1. Log into eFSAP. Click on Form 4. Click Create Form 4A – Section A&B. If completing the remainder of a Form 4 from an immediate notification, access the previously submitted Form 4 by clicking on the View buttonimage icon adjacent to the appropriate ID under Form 4 Section A&B.
  2. Fill out Section A.
    1. Answer Questions 1–3. Questions 4-13 should be filled out automatically.
  3. Fill out Section Bimage icon.
    1. For Question 1, select the closest agent or toxin identified.
    2. For Question 6, if the sample origin is international, leave this field blank or enter “00000”. Provide the international location in the Question 16 comments box.
    3. For Question 8image icon, you may select more than one option:
      1. Transferred – Indicate to whom the sample was sent and the date of the transfer.
      2. Destroyed – Indicate method of destruction and date destroyed.
      3. Retained – Indicate PI from the dropdown menu of PIs approved to possess select agent and toxin.
    4. If you answer yes to Question 9, you will need to fill out an APHIS/CDC Form 3 as well.
    5. If you answer yes to Question 11, you will also need to answer questions 12-15. Click Add Rowimage icon.
  4. Note: If the sample provider submitted the entire specimen to the reference laboratory and did not work on the specimen, the reference laboratory must note this in the comment field.
  5. For international sample providers, provide any additional details on the sample provider here, including the date the sample provider was notified of the identification.
  6. Click Submitimage icon. Clicking Save does NOT submit the Form 4 Section A&B.
Page last reviewed: August 27, 2020