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pdfUnited States Department of Agriculture
SMALL ENTERPRISE CHICKEN
REPORT
Animal and Plant Health Inspection Service
Veterinary Services
Centers for Epidemiology and Animal Health
2150 Centre Ave., Bldg. B
Fort Collins, Co 80526-8117
Form Approved
NAHMS-200
O.M.B. Number 0579-0260
Project Code 941
July 2007
Please make corrections to name, address and Zip Code, if necessary.
1. Between October 2006 and September 2007, were or will there be any chickens present on this operation, including
roosters, hens, or chicks?
1
YES – Go to Question 2, below
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3
0101
NO – Go to Conclusion on the back page
Largest
Number
0102
2. From October 2006 until April 2007, what was the largest number of chickens on hand on any one
day?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Largest
Number
0103
3. From May 2007 until September 2007, what was or will be the largest number of chickens on hand
on any one day?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. As of today, how many birds of the following types are on your operation:
Birds
a. Chickens for table-egg production?.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +
0104
+
0105
Breeding chickens for hatching egg production (including hens, roosters, etc.)?. . . . . . . . . . . . . . .
+
0106
d. Chickens – other? (Examples: show, exhibition, gamefowl chickens, etc.).. . . . . . . . . . . . . . . . . . . . . . .
+
0107
e. Turkeys?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
+
0108
Waterfowl? (Examples: ducks, geese, swans, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +
0109
g. Pigeons or doves?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
+
0110
h. Game birds? (Examples: quail, pheasant, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
+
0111
i.
Guinea Fowl?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +
0112
j.
Pet birds? (Examples: parrots, parakeets, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +
0113
k.
Other types of birds? (Specify:__________________________________) . . . . . . . . . . . . . . . . . . . . . .
+
0114
Total number of birds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . =
0115
b. Chickens for meat production? . . . . . . . . . . . . . . . .
c.
f.
.................................................
-2-
5. From October 2006 until April 2007, did any of your poultry (including game birds) have
outdoor access; either free ranging in outdoor pens or housed indoors with the ability to
go outside?
1
YES – What percentage of your flock had outdoor access from October until April?
3
Percent
0116
NO
6. From May 2007 until September 2007, did or will any of your poultry (including game
birds) have outdoor access either free ranging in outdoor pens or housed indoors with the
ability to go outside?
Percent
0118
1
YES – What percentage of your flock had or will have outdoor access
from May until September?
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0117
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0119
3
NO – If Questions 5 and 6 are NO go to Question 10
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0120
7. For birds that have access to the outdoors, are any of these birds able to leave the property
(even if they do not)?
1
YES
3
NO
8. How do you distribute feed to your birds when outdoors?
[Check the method used most often.]
a.
1 Birds
are not fed outdoors
b.
2 Feed
is scattered on the ground
c.
3
d.
4 Birds
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0121
Birds are fed using an open trough
are fed using a covered feeder
9. How is water delivered to your birds when outdoors?
[Check the method used most often.]
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0122
a.
1
Birds must come indoors to drink
b.
2
Birds drink from a body of surface water, such as a pond, lake, or a stream
c.
3
Birds drink from an open or partially covered trough or bell waterer
d.
4
Birds drink from an enclosed water receptacle, such as a
sipper/nipple waterer
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10. Do you operate under a contract with a poultry company?. . . . . . . . .
1
3
0123
1
3
0124
1
3
0125
1
3
0126
1
3
0127
1
3
YES
NO
11. Do you consider any part of your operation to be any of the following:
a. Natural? (no feed additives fed). . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Organic? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(i) If YES, is your operation certified organic?. . . . . . . . . . . . . . . .
c.
Free range or pasture raised?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Cage free layers [Check n/a if there are no egg layers]?. . . . . . .
.
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YES
YES
YES
YES
YES
NO
NO
NO
NO
NO
4
N/A
0128
-3-
12. In the last 12 months, were any live poultry (including game birds)
permanently removed from your operation (i.e., sold, given away, or removed
through contract)? Include poultry and game birds going to all destinations,
including slaughter.
Times
1
YES - How many times were live birds permanently removed from your
operation (i.e. sold, given away, or removed through contract)?
Include birds sent to slaughter.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0129
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0130
3
NO - Go to Question 14
13. Were any of these live birds sold or given away through the following
channels? If YES, on average, how many miles do the birds usually travel one
way from your farm to the following destination?
0140
1
3
0132
0141
1
3
0133
0142
1
3
0134
0143
1
3
0135
0144
1
3
0136
0145
1
3
0137
0146
1
3
0138
0147
1
3
0139
0148
NO
NO
YES
d. Flea market, farmer’s market or swap meet. . . . . . . . . . . . . . . .
NO
YES
e. Fair or show. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NO
YES
Auction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NO
YES
g. Directly to slaughter (slaughter facility or home slaughter). . .
NO
YES
h. Returned to contractor/poultry company. . . . . . . . . . . . . . . . . . .
i.
0131
NO
YES
Farm store or feed store. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f.
3
YES
b. Another premises with poultry (including game birds). . . . . . .
NO
YES
Other (Specify:______________________________________). . . . . .
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1
YES
a. Live bird market. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c.
Distance
(miles)
NO
14. In the last 12 months, were any day old chicks or hatchlings placed on your
operation? (Exclude birds hatched on your operation.)
Times
1
YES – How many times were day-old chicks or hatchlings placed on your
operation?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0149
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0150
3
NO
15. In the last 12 months, were any older birds, not hatchlings placed on your
operation?
Times
1
YES – How many times were older birds, not hatchlings, placed on your
operation?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0151
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0152
3
NO – Go to Question 17
16. In the last 12 months, did any of these older birds come from the following
sources? If YES, what was the usual distance (miles) traveled from the source?
a. Poultry wholesaler or dealer. . . . . . . . . . . . . . . . . . . . . . . . . .
b. Directly from another premises with poultry (including
game birds). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
YES
3
NO
Distance
(miles)
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0153
0160
0154
0161
1
3
1
3
0155
0162
d. Flea market, farmer’s market, or swap meet. . . . . . . . . . . .
1
3
0156
0163
e. Fair or show. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
3
0157
0164
f.
1
3
0158
0165
1
3
0159
0166
c.
Farm store or feed store. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Auction market. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g. Other (Specify:________________________________)
......
YES
YES
YES
YES
YES
YES
NO
NO
NO
NO
NO
NO
-4-
17. In the last 12 months, did you take any of your poultry (including game birds) to a
location (e.g., a fair or show) where birds were present and then returned your
birds to your operation?
1
YES – How many times did you do this in the last 12 months?. . . . . . . . . . . . . . . .
Times
0167
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0168
3
NO
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0169
18. Does your operation sell, give away, or remove through contract, any
hatching or table eggs?
1
YES
3
NO – Go to Question 21
19. Are eggs removed from your operation in any of the following ways?
If YES, how many times per week are eggs removed the following ways?
Times/week
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a. Operation delivers eggs to destination. . . . . . . . . . . . . . . . .
1
3
0170
0173
b. Customer picks up eggs on site for their own use. . . . . . . .
1
3
0171
0174
0172
0175
1
3
c.
Commercial egg pick-up or eggs picked up through
contract arrangements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES
YES
YES
NO
NO
NO
20. Are the egg cartons, crates, flats, or racks that are used on your operation also
used on another operation? [Check N/A if not used on your operation.]
a. Cartons. . . . . . . . . . . . . . . . . . . . . . . .
1
2
3
b. Crates. . . . . . . . . . . . . . . . . . . . . . . . .
1
2
3
c.
Flats. . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2
3
d. Racks. . . . . . . . . . . . . . . . . . . . . . . . . .
1
2
3
YES
YES
YES
YES
Don’t Know
Don’t Know
Don’t Know
Don’t Know
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NO
1
b.
2 Carcass
c.
3 Bury
d.
4 Incinerate
e.
5 Compost
f.
6 Taken
g.
7 Put
h.
8 Fed
i.
9 Added
j.
10Other
taken to renderer
on premises
to a landfill
in trash (picked up)
to other animals
to manure pile
method (Specify:___________________________)
4
0177
4
0178
4
0179
N/A
NO
N/A
NO
N/A
NO
Renderer pick up. How many times in the past 3 months have carcasses
been picked up by a renderer?
0176
N/A
21. Which of the following is the primary method of disposing of dead birds including
frozen carcasses?
[Check one.]
a.
4
Times
0180
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0181
-5-
Days/week
22. How many days per week are your birds observed by yourself or someone else who
would notice if they had a health problem?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0182
23. Do any paid or unpaid workers on your poultry operation, including yourself and
family members work on other operations or for another business that handles live
or dead birds?
1
YES – How many paid or unpaid workers, including yourself and family
members, work on other operations or for another business that
handles live or dead birds?
Workers
0183
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0184
2
DON’T KNOW
3
NO
24. Do any paid or unpaid workers on your poultry operation, including yourself and
family members, have pet birds or poultry (including game birds) at their home?
1
Workers
0185
YES – How many paid and unpaid workers, including yourself and
family members, have pet birds or poultry at their home?
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0186
2
DON’T KNOW
3
NO
25. In the last year, did any paid or unpaid workers on your poultry
operation, including yourself and family members, visit the following
types of places? [Check all that apply.] For each box that is
checked how many times during the last year was the place visited
and approximately how many miles were traveled one way?
a.
1
Egg processing plant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b.
1
Hatchery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c.
1
Poultry slaughter facility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d.
1
Premises where poultry are raised. . . . . . . . . . . . . . . . . . . . . .
e.
1
Live bird market. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f.
1
Facility that sells poultry (e.g., auction, flea market,
swap meet). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g.
1
Feed store or feed mill. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
h.
1
Rendering facility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number of
Times per
Year
Distance
(miles)
0187
0195
0203
0188
0196
0204
0189
0197
0205
0190
0198
0206
0191
0199
0207
0192
0200
0208
0193
0201
0209
0194
0202
0210
26. Do you always, sometimes, or never require the following measures for workers,
including the flock owner, entering the bird production area of your operation?
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a. Shower. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
b. Change into clean clothes or coveralls. . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
c.
1
Always
2
Sometimes
3
Never
d. Use of footbath before entry. . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
e. Scrub shoes before entry. . . . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
f.
Scrub shoes after exit. . . . . . . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
g. Wash hands before handling birds. . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
h. Wash hands after handling birds. . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
Change into clean boots or use shoe covers. . . . . .
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0211
0212
0213
0214
0215
0216
0217
0218
-6-
27. Did any of the following types of people visit your operation in the
last 12 months? [Check all that apply] For each box that is checked,
approximately how many times per month or year do the following
types of people visit your operation?
Per Month
OR
Per Year
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0219
0233
0247
0220
0234
0248
Catch crew (workers who are not employees on your
operation, who professionally catch birds to remove them
from your operation). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0221
0235
0249
0222
0236
0250
0223
0237
0251
0224
0238
0252
0225
0239
0253
0226
0240
0254
a.
1
Private veterinarian or company veterinarian. . . . . . . . . . . . . . .
b.
1
Service person employed by poultry company. . . . . . . . . . . . . .
c.
1
d.
1
Crew for vaccination or other medical procedures (workers
who are not employees of your operation). . . . . . . . . . .. . . . . .
e.
1
State or Federal veterinarian or animal health worker.. . . . .
f.
1
University veterinarian or cooperative extension agent. . . . .
g.
1
Feed delivery personnel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
h.
1
Nutritionist or feed company representative. . . . . . . . . . . . . . . . .
i.
1
Customer (private individual) purchasing birds, meat,
eggs, or other bird products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0227
0241
0255
j.
1
Bird wholesaler, buyer, or dealer
(including live bird market owner).. . . . . . . . . . . . . . . . . . . . . . . . .
0228
0242
0256
k.
1
Service person for facilities or equipment
(e.g., meter reader, plumber, electrician, etc.) . . . . . . . . . . . . . .
0229
0243
0257
l.
1
Inspector (e.g., county health inspector or official there
to certify birds as organic).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0230
0244
0258
m.
Other people visiting for business purposes. . . . . . . . . . . . . . . .
0231
0245
0259
1
n.
1
Non-business visitors (e.g., school groups, friends, or
neighbors just coming by to see the birds). . . . . . . . . . . . . . . . .
0232
0246
0260
28. Did any of the people in Question 27 above enter the bird production area?
1
YES
3
NO – Go to Question 30
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0261
29. Do you always, sometimes, or never require the following measures
for people other than employees entering the bird production area of your operation?
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a. Change into clean clothes or coveralls. . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
b. Change into clean boots or use shoe covers. . . . . . .
1
Always
2
Sometimes
3
Never
c.
Use of footbath before entry. . . . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
d. Scrub shoes before entry. . . . . . . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
e. Scrub shoes after exit. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
f.
Wash hands before handling birds. . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
g. Wash hands after handling birds. . . . . . . . . . . . . . . . . . .
1
Always
2
Sometimes
3
Never
1
Always
2
Sometimes
3
Never
1
Always
2
Sometimes
3
Never
h. No contact with other birds for at least 24 hours
before entering the bird production area . . . . . . . . . . .
i.
Park away from bird area. . . . . . . . . . . . . . . . . . . . . . . . . .
0262
0263
0264
0265
0266
0267
0268
0269
0270
-7-
30. In the past 12 months, did your operation share equipment including equipment that
you lent, borrowed, or co-owned with another poultry operation?
1
YES – How many times did your operation share equipment in the
past 12 months?
3
NO
Times
0271
31. Do you usually, sometimes or never see the following animals or evidence of the following animals
in the bird production area? (Include indoor and outdoor bird areas.)
a. Wild waterfowl. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Usually
2
Sometimes
3
Never
b. Wild birds other than waterfowl. . . . . . . . . . . . . . . . . . . .
1
Usually
2
Sometimes
3
Never
c.
1
Usually
2
Sometimes
3
Never
1
Usually
2
Sometimes
3
Never
1
Usually
2
Sometimes
3
Never
Rodents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Wild animals other than rodents (e.g. feral cats,
raccoons, skunks, possums, etc.). . . . . . . . . . . . . . . . . .
e. Poultry from a neighbor. . . . . . . . . . . . . . . . . . . . . . . . . . . .
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0272
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0273
0274
0275
0276
32. Do you usually, sometimes or never see the following animals or evidence of the following animals
in the feed storage area?
0277
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a. Wild waterfowl. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Usually
2
Sometimes
3
Never
0278
b. Wild birds other than waterfowl. . . . . . . . . . . . . . . . . . . .
1
Usually
2
Sometimes
3
Never
0279
c.
1
Usually
2
Sometimes
3
Never
0280
1
Usually
2
Sometimes
3
Never
1
Usually
2
Sometimes
3
Never
Rodents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Wild animals other than rodents (e.g. feral cats,
raccoons, skunks, possums, etc.). . . . . . . . . . . . . . . . . .
e. Poultry from a neighbor. . . . . . . . . . . . . . . . . . . . . . . . . . . .
0281
0282
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33. Is there a pond, lake, or stream on your property?. . . . . . . . . . . . . . . .
1
34. How frequently is poultry litter or poultry manure hauled off your property?
a.
1
Litter or manure remains in house or is spread or stored
on property
b.
2
Litter or manure is hauled off property at least once per
month
c.
3
Litter or manure is hauled off property at least once per
year
d.
4 Litter
e.
5 Litter
or manure is hauled off property once every 2
years
or manure is hauled off property once every 3 or
more years
YES
3
NO
0283
Office Use
0284
-8-
35. In the past 12 months, have you spread litter or manure from another poultry operation
onto your fields?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
YES – How many times have you spread litter or manure from another poultry
operation onto your field?
3
NO – Go to Question 37
Times
Office Use
0285
0286
Miles
0287
36. Approximately how far away, in miles, was the operation where you got the litter or
manure?
37. How important to you are the following sources of bird health information?
Office Use
a. Extension Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
b. Feed Store. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
c.
Nutritionist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
d. Internet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
e. Books/Magazines/Journals. . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
f.
Medical supplier/salesperson. . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
g. Other producers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
1
Very
2
Somewhat
3
Not important
1
Very
2
Somewhat
3
Not important
1
Very
2
Somewhat
3
Not important
Veterinarian (private practitioner). . . . . . . . . . . . . .
j.
Federal, State, or university veterinarian or
diagnostic lab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0289
0290
0291
0292
0293
0294
0295
h. Service person employed by a poultry
contractor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i.
0288
0296
0297
k.
Industry associations or organizations. . . . . . . . . .
1
Very
2
Somewhat
3
Not important
l.
Other sources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Very
2
Somewhat
3
Not important
0298
0299
CONCLUSION
THAT COMPLETES OUR SURVEY. THANK YOU FOR YOUR HELP.
Respondent Name: ____________________________________________________________ Date: _______________________________
9910
MM
DD
YY
Date:
OFFICE USE
Response
1-Comp
2-R
3-Inac
4-Office Hold
5-R – Est
6-Inac – Est
7-Off Hold – Est
8-Known Zero
Respondent
9901
1-Op/Mgr
2-Sp
3-Acct/Bkpr
4-Partner
9-Oth
9902
Mode
1-Mail
2-Tel
3-Face-to-Face
4-CATI
5-Web
6-e-mail
7-Fax
8-CAPI
19-Other
Enum.
9903
098
Eval.
100
Office Use for POID
789
__ __ __ - __ __ __ - __ __ __
Optional Use
407
408
S/E Name
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays
a valid OMB control number. The valid OMB control number for this information collection is 0579-0260. The time required to
complete this information collection is estimated to average 30 minutes per response, including the time to review instructions, search
existing data resources, gather the data needed, and complete and review the information collected.
NAHMS-200
July 2007
| File Type | application/pdf |
| File Title | Microsoft Word - SMALLCHICKENENTERPRISEREPORT_HQ-7_1_2007 _5_.doc |
| Author | aberry |
| File Modified | 2007-07-09 |
| File Created | 2007-07-09 |