Provide comprehensive identification and risk characterization for all biological materials proposed for transfer. Accurate classification is critical for determining packaging, transport, and containment requirements.
Primary Sample Material ID Number
Additional Sample Alias or Internal Tracking Code
Scientific Name of Biological Agent (Genus and Species)
Strain Designation or Isolate Identifier
WHO Risk Group Classification
Risk Group 1 (no or low individual and community risk)
Risk Group 2 (moderate individual risk, low community risk)
Risk Group 3 (high individual risk, low community risk)
Risk Group 4 (high individual and community risk)
Does this material contain genetically modified organisms (GMOs) or recombinant nucleic acids?
Is this agent known to produce toxins or biologically active metabolites?
Does this agent exhibit zoonotic potential or cross-species transmission capability?
Estimated Infectious Dose (ID50) in laboratory model if known
Infectious Dose Unit
Has this material been inactivated or attenuated?
Brief description of material composition and matrix
Total volume or mass of material to be transferred
Volume/Mass Unit
Number of individual containers/vials in shipment
Does material require any special handling beyond standard BSL practices?
Complete identification and verification of all facilities and responsible personnel involved in the transfer. International transfers require additional documentation.
Sending Institution/Laboratory Full Legal Name
Sending Facility Complete Physical Address
Sending Facility BSL Level Certification
Sending Principal Investigator Full Name
Sending PI Professional Title/Position
Sending PI Email Address
Sending PI Direct Phone/24-Hour Emergency Contact
Sending Facility Biosafety Officer Name
Sending Facility BSO Email and Phone
Is this an international transfer across national borders?
Receiving Institution/Laboratory Full Legal Name
Receiving Facility Complete Physical Address
Receiving Facility BSL Level Certification
Receiving Principal Investigator Full Name
Receiving PI Professional Title/Position
Receiving PI Email Address
Receiving PI Direct Phone/24-Hour Emergency Contact
Receiving Facility Biosafety Officer Name
Receiving Facility BSO Email and Phone
Has the receiving facility confirmed BSL compatibility and adequate containment capabilities?
Verify complete compliance with triple packaging system requirements and cold-chain integrity. All packaging must meet UN standards for infectious substance transport.
Primary Container Type (Leak-proof Primary Receptacle)
Sealed cryovial with O-ring
Screw-capped tube with gasket
Sealed ampoule
Vacuum-sealed pouch
Other certified primary container
Primary Container Material and Volume Capacity
Is primary container individually wrapped in absorbent material?
Secondary Packaging Type (Water-tight Leak-proof Receptacle)
Secondary Packaging UN Certification Number
Does secondary packaging contain sufficient absorbent for all primary containers?
Outer Packaging Type (Rigid Protective Outer Receptacle)
Outer Packaging UN Specification Marking
Is complete triple packaging system certified for air transport (IATA PI 620 or PI 650)?
Temperature Maintenance Requirements During Transit
Ambient temperature (15-25°C)
Refrigerated (2-8°C)
Frozen (-20°C)
Deep frozen (-80°C)
Cryogenic (liquid nitrogen, -196°C)
Controlled room temperature with monitoring
Is a temperature monitoring device (data logger) included in shipment?
Have all exterior surfaces of outer packaging been decontaminated?
Are complete shipping documents externally attached in document pouch?
I certify that packaging has been inspected and meets all triple packaging system requirements
Detailed transport logistics and emergency response preparedness are mandatory for all biological material transfers, especially for Risk Group 3 and 4 agents.
Primary Mode of Transport
Commercial air freight (passenger aircraft)
Commercial air cargo (dedicated freighter)
Ground courier (dedicated vehicle)
Ground postal service (registered)
Hand-carried by authorized courier
Ship/sea freight
Carrier Company Name and Account Number
Carrier Emergency Contact Number (24-hour)
Scheduled Shipment Departure Date and Time
Estimated Total Transit Duration (hours)
Will shipment transit through intermediate handling facilities or customs checkpoints?
Is shipment equipped with GPS real-time tracking?
EMERGENCY SPILL CONTINGENCY - Complete for all Risk Group 2, 3, and 4 materials
Has a written Emergency Action Plan (EAP) been provided to carrier?
Spill Response Kit Contents and Location During Transit
24-Hour Emergency Contact for Spill Response (Primary)
24-Hour Emergency Contact for Spill Response (Secondary)
Nearest Qualified Decontamination Facility to Transit Route
Has carrier personnel received biohazard spill response training?
Communication Protocol in Case of Transit Delay, Temperature Excursion, or Spill Event
Are there any geopolitical restrictions or sanctions affecting this transfer route?
Final authorization requires documented IBC approval, comprehensive risk assessment, and sign-off from all responsible authorities. Transfer cannot proceed without complete documentation.
Sending Facility IBC Approval Reference Number
Sending Facility IBC Approval Date
Sending Facility IBC Approval Expiration Date
Does sending IBC approval specifically authorize this material transfer?
Receiving Facility IBC Approval Reference Number
Receiving Facility IBC Approval Date
Receiving Facility IBC Approval Expiration Date
Does receiving IBC approval specifically authorize receipt and possession of this agent?
Has a comprehensive Material Transfer Agreement (MTA) been executed between institutions?
Upload complete risk assessment documentation for this transfer
Does this transfer involve any dual-use research of concern (DURC) considerations?
Have all personnel involved in packaging and transport received agent-specific safety training?
Final Packaging Inspection and Sign-off Timestamp
I certify that all information provided is accurate and complete to the best of my knowledge
I acknowledge that incomplete or inaccurate information may result in transport delays, regulatory violations, or biosafety incidents
I confirm that emergency response procedures have been communicated to all parties and are readily accessible during transit
Sending Principal Investigator Digital Signature
Sending Facility Biosafety Officer Digital Signature
Receiving Principal Investigator Digital Signature (Pre-receipt Acknowledgment)
Receiving Facility Biosafety Officer Digital Signature (Pre-receipt Verification)
Final IBC Administrative Review and Authorization Timestamp
Institutional Biosafety Committee Chair or Designated Reviewer Signature
Final Authorization Reference Code