"Animal Health Commodity Order Form" - Illinois

Animal Health Commodity Order Form is a legal document that was released by the Illinois Department of Agriculture - a government authority operating within Illinois.

Form Details:

  • The latest edition currently provided by the Illinois Department of Agriculture;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Illinois Department of Agriculture.

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Download "Animal Health Commodity Order Form" - Illinois

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Illinois Department of Agriculture
Bureau of Animal Health & Welfare
Block Agriculture Building, State Fairgrounds
Springfield, IL 62794-9281
217 782-4944
FAX 217 558-6033
ANIMAL HEALTH COMMODITY ORDER FORM
Veterinarian:______________________________ Practice name:_____________________________
Shipping address:____________________________________________________________________
City:__________________________________ State:___________ Zip:________________________
Telephone:____________________________ Email:_______________________________________
Accountable commodities (tags, sequentially numbered forms, and tuberculin) must be assigned to a
specific veterinarian (not just to a practice). Please complete a separate form for each veterinarian.
Forms and tags are shipped in full packages only.
Number of
Number per
packages
Form number
Form description
Package
4-52A
Back tag report
50
4-33
Brucellosis test record
50
50
4-33A
Brucellosis test record continuation page
10-11
EIA test record
50
M120
Health certificate, livestock
25
M119
Health certificate, small animals
100
1-27
Movement permit (Auction Market Veterinarians Only
50
)
C-37
Quarantine form (Auction Market Veterinarians Only)
50
6-22
Tuberculosis test record
50
4-26
Vaccination record
100
Tag
Large animal identification tags
100
Tag
Swine feeder pig identification tags
100
Tag
Brucellosis vaccination tags
100
Tuberculin* (PPD, for program use)
1 ml vial
Blood tube mailing boxes are no longer available
When completed, click the "Submit by email" button or save
form to your computer and email it to agr.cvi@Illinois.gov
SUBMIT BY EMAIL
All orders subject to a $5.00 accession fee and shipping charges.
*To order tuberculin for non-program (export) use, please contact the National Veterinary Services
Laboratory at
https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/lab-info-services/SA_Reagents
Reagent code 30-EXP. Orders are not accepted by telephone.
Illinois Department of Agriculture
Bureau of Animal Health & Welfare
Block Agriculture Building, State Fairgrounds
Springfield, IL 62794-9281
217 782-4944
FAX 217 558-6033
ANIMAL HEALTH COMMODITY ORDER FORM
Veterinarian:______________________________ Practice name:_____________________________
Shipping address:____________________________________________________________________
City:__________________________________ State:___________ Zip:________________________
Telephone:____________________________ Email:_______________________________________
Accountable commodities (tags, sequentially numbered forms, and tuberculin) must be assigned to a
specific veterinarian (not just to a practice). Please complete a separate form for each veterinarian.
Forms and tags are shipped in full packages only.
Number of
Number per
packages
Form number
Form description
Package
4-52A
Back tag report
50
4-33
Brucellosis test record
50
50
4-33A
Brucellosis test record continuation page
10-11
EIA test record
50
M120
Health certificate, livestock
25
M119
Health certificate, small animals
100
1-27
Movement permit (Auction Market Veterinarians Only
50
)
C-37
Quarantine form (Auction Market Veterinarians Only)
50
6-22
Tuberculosis test record
50
4-26
Vaccination record
100
Tag
Large animal identification tags
100
Tag
Swine feeder pig identification tags
100
Tag
Brucellosis vaccination tags
100
Tuberculin* (PPD, for program use)
1 ml vial
Blood tube mailing boxes are no longer available
When completed, click the "Submit by email" button or save
form to your computer and email it to agr.cvi@Illinois.gov
SUBMIT BY EMAIL
All orders subject to a $5.00 accession fee and shipping charges.
*To order tuberculin for non-program (export) use, please contact the National Veterinary Services
Laboratory at
https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/lab-info-services/SA_Reagents
Reagent code 30-EXP. Orders are not accepted by telephone.