Form CF.ACC.4.3 "Bvd Virus Ear Notch Testing Submission Form" - Alabama

What Is Form CF.ACC.4.3?

This is a legal form that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the Alabama Department of Agriculture and Industries;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CF.ACC.4.3 by clicking the link below or browse more documents and templates provided by the Alabama Department of Agriculture and Industries.

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Download Form CF.ACC.4.3 "Bvd Virus Ear Notch Testing Submission Form" - Alabama

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Thompson-Bishop-Sparks
Accession #:
State Diagnostic Laboratory
890 Simms Road
Date:
Auburn, AL 36832
Case
(334) 844-4987 Fax (334) 844-7224
Coordinator:
 Charge
 N/C
 CA
 CK
BVD Virus Ear Notch Testing
Paid:
$
 USPS
 UPS
 FedEx
 Other
Submission Form
Feedback Report
Submitted samples become the property of the laboratory
Other:
Veterinarian
Producer/Owner
Clinic
Business
License #
Account #
County
Premise ID
Address
Address
Phone
Phone
Fax
Fax
Email
Report Format
Mail
Fax
Ear notcher Requested
Submitted by:
Veterinarian
Producer/Owner
Other
Bill to:
Veterinarian
Producer/Owner
Other
 Authorization to share results with Program Coordinator, Dr. Soren Rodning, 334-844-7502
To obtain BVDV sample collection tubes, contact the diagnostic lab 334-844-7226. For sample collection, refer to the instructions
enclosed with the collection tubes. Enter animal identification one animal per line; mark animals submitted for re-test.
Breed
Sex M/F
Age
Specimen
Animal Identification
Re-test
No.
1
2
3
4
5
6
7
8
9
10
Some testing may be subcontracted out to qualified laboratories. You will be contacted for permission if this will incur further charges.
Print name
____ Signature _____
____ Date
CF.ACC.4.3 BVD Submission Form
AG
January 2016
Page 1 of 3
Thompson-Bishop-Sparks
Accession #:
State Diagnostic Laboratory
890 Simms Road
Date:
Auburn, AL 36832
Case
(334) 844-4987 Fax (334) 844-7224
Coordinator:
 Charge
 N/C
 CA
 CK
BVD Virus Ear Notch Testing
Paid:
$
 USPS
 UPS
 FedEx
 Other
Submission Form
Feedback Report
Submitted samples become the property of the laboratory
Other:
Veterinarian
Producer/Owner
Clinic
Business
License #
Account #
County
Premise ID
Address
Address
Phone
Phone
Fax
Fax
Email
Report Format
Mail
Fax
Ear notcher Requested
Submitted by:
Veterinarian
Producer/Owner
Other
Bill to:
Veterinarian
Producer/Owner
Other
 Authorization to share results with Program Coordinator, Dr. Soren Rodning, 334-844-7502
To obtain BVDV sample collection tubes, contact the diagnostic lab 334-844-7226. For sample collection, refer to the instructions
enclosed with the collection tubes. Enter animal identification one animal per line; mark animals submitted for re-test.
Breed
Sex M/F
Age
Specimen
Animal Identification
Re-test
No.
1
2
3
4
5
6
7
8
9
10
Some testing may be subcontracted out to qualified laboratories. You will be contacted for permission if this will incur further charges.
Print name
____ Signature _____
____ Date
CF.ACC.4.3 BVD Submission Form
AG
January 2016
Page 1 of 3
Accession #
Page _____/______
BVD Sample Continuation Sheet -- Print or Copy As Needed
Continue
numbers
Animal Identification
from
Re-test
previous
Breed
Sex M/F
Age
page
CF.ACC.4.3 BVD Submission Form
AG
January 2016
Page 2 of 3
Accession #
Page _____/______
BVD Sample Continuation Sheet -- Print or Copy As Needed
Continue
numbers
Animal Identification
from
Re-test
previous
Breed
Sex M/F
Age
page
CF.ACC.4.3 BVD Submission Form
AG
January 2016
Page 3 of 3
Page of 3