Completed Shipper's Declaration For Dangerous Goods Form

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The page below is a sample from the LabCE course Packaging and Shipping Infectious Materials (retired 6/6/2018). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Completed Shipper's Declaration For Dangerous Goods Form

This is an example of a Shippers Declaration form that has been completed correctly. Compliance checking software will guide you through each step. However, errors could still occur. Here are some examples of errors that could cause the package to be rejected by the carrier:
  • Omitting part of the emergency response information-- ensure you have included the first and last name of the responsible person and the emergency telephone number, including area code.
  • Using abbreviations, acronyms, or codes for packaging descriptions. For example, fiberboard box would be the correct way to describe this type of packaging and not "4G," which is the identification code for a fiberboard box.
  • Unacceptable technical names
    • If the pathogen is known, use the scientifically accepted name of the disease causing agent. For example, as shown on the form on the right, spell out Mycobacterium tuberculosis rather than writing it as M. tuberculosis or Tb.
    • If the pathogen is unknown, use the exact wording of this phrase in the exact order that is shown: For UN2814, write the proper shipping name as, Infectious substance, affecting humans (suspected category A infectious substance); for UN2900, write the proper shipping name as, Infectious substance, affecting animals (suspected category A infectious substance).