LIST OF SURVEY QUESTIONS
1. Name of Laboratory ________________________________________________________________
2. Address of Laboratory_______________________________________________________________
3. Pathologist & contact information _____________________________________________________
4. Chief Medical Technologist & contact information ________________________________________
5. Owner of the laboratory & contact information __________________________________________
6. Ownership________________________________________________________________________
7. Function _________________________________________________________________________
8. Institutional character_______________________________________________________________
9. Service Capability __________________________________________________________________
10. Cold storage _____________________________________________________________________
11. Inventory
Sample
a. Stool
b. Throat swab
c. Blood
d. Cerebrospinal fluid
e. Unfixed Autopsy
Materials
f. Sewage Samples
g. Environmental
samples
h. Non- polio Enterovirus
isolates
i. Oral poliovirus
vaccine/Sabin vaccine
isolates
j. Wild poliovirus
k. Vaccine derived
poliovirus
l. Animal samples
infected with wild
poliovirus
m. Clinical specimens
from any polio patient
n. Research materials
Does your lab handle this?
For how long?
How do you discard this?
(Y/N)
(Discard immediately, after shift, kept
at cold storage, etc.)
(Chemical, heat, c/o waste management, etc)