REPORTING: Funded Projects Pilot; Developing Standardized Forms

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Overview

Coversheet
HF and AF Data

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Sheet 1: Coversheet

	Recipent Name (Select)		Select
	State		Select Recipient Name
	Federal Award Identification Number		Select Recipient Name
	Report Frequency
	Date Completed
	Project Period Start Date
	Project End Date
	Budget Period Start Date
	Budget Period End Date
	Principal Investigator (PI)
	PI Email
	PI Phone

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Sheet 2: HF and AF Data

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)

Lab Name

State

Sample Number (ID)

LFFM Track

Commodity Category (Assigned)

Target Species (animal) - AF Track Only

Form of Feed - AF Track Only

Product Description

Manufacturer/Brand

Product Code or Lot

Expiration Date

Country of Origin

Collecting Entity

Collection Location

Collection Date

Lab Receipt Date

Salmonella Analysis Start Date

Salmonella Screen Result

Salmonella Confirmatory Result

Salmonella Final Result

Salmonella Serotype

Salmonella Analysis Completion Date

Salmonella Analysis Turn-Around-Time

BSE Prohibited Materials Analysis Start Date

BSE Prohibited Material Final Result

BSE Analysis Completion Date

BSE Analysis Turn-Around-Time

L. monocytogenes Analysis Start Date

L. monocytogenes Screen Result

L. monocytogenes Confirmatory Result

L. monocytogenes Final Result

L. monocytogenes Analysis Completion Date

L. monocytogenes Analysis Turn-Around-Time

EHEC/STEC Analysis Start Date

EHEC/STEC Screen Result

EHEC/STEC Confirmatory Result

EHEC/STEC Final Result

EHEC/STEC Analysis Completion Date

EHEC/STEC Analysis Turn-Around-Time

Cyclospora cayetanensis Analysis Start Date

Cyclospora cayetanensis Final Result

Cyclospora cayetanensis Analysis Completion Date

Cyclospora Analysis Turn-Around-Time

WGS Date Isolate Submitted

WGS Isolate ID

WGS Results (Serotype, Clusters, etc.)

WGS Date Data Submitted

WGS Analysis Turn-Around-Time

Norovirus Analysis Start Date

Norovirus Final Result

Norovirus Analysis Completion Date

Norovirus Analysis Turn-Around-Time

Camplylobacter Analysis Start Date

Campylobacter Final Result

Campylobacter Analysis Completion Date

Campylobacter Analysis Turn-Around-Time

Other Analyte1 (Pick from Drop Down)

Other Analyte1 Result

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