Strategic National Stockpile Weekly Dispensing Report Form

The "Strategic National Stockpile Weekly Dispensing Report" is due by close of business every Wednesday. The report should include the aggregate numbers covering the entire reporting period. The form has a "send email" button at the bottom for submitting the form.

There are drop-down boxes to aid in filling out this form quickly. As well, using the tab button will allow ease in preparing this form.

Please indicate what type of facility you are reporting for, the name and county of the facility as well as the date.

Under the heading "Strategic National Stockpile Assets" please indicate assets you have received from the state is in stock in your facility/pharmacy. If you have not received any masks please indicate by inserting a zero.

Please indicate, if at all possible, the priority groups you have dispensed antivirals. If this is not possible please enter the total amount of antivirals you have dispensed.

When complete, click on the "submit by email" button to send your data to the Georgia Strategic National Stockpile Program. The form will not let you submit unless the total number boxes have been completed.

Once you click submit, a box will appear asking if you want to send utilizing your desktop email, which is the email you use on a daily basis, normally provided by your company. If you do not utilize company email servers you may click on the Internet based email button.

Internet based email users: If you use an internet based email service (Google, Yahoo, AOL, etc.), you will have the option to save the data from the completed form to your computer after clicking "send email". You can then use the email service of your choice to attach the form and submit the form to us. Please return all forms to sns@dhr.state.ga.us.
Please use the following subject header: "SNS Report".

Weekly SNS Dispensing Form

© 2011 Georgia Department of Public Health