NAHMS-221 Goat 2009 Parasite Evaluation Collection Record

National Animal Health
Monitoring System
Animal and
Plant Health
Inspection
Service

2150 Centre Ave, Bldg B
Fort Collins, CO 80526

Goat 2009
Parasite Evaluation
Collection Record

Veterinary
Services

Form Approved
OMB Number 0579-xxxx
Expiration date: xxx

Last date to take samples is XX , 2009
Samples must be shipped on Monday, Tuesday, or Wednesday.
State:

Operation Number:

Collection date:

Kit Number:

(from Producer Agreement)

(mm/dd/yy)

BE SURE TO ONLY COLLECT SAMPLES FROM GOATS 2 years or older.

1. Write down the age of each animal you take a fecal sample from like the example in the first column.
Enter the number of samples taken into the table above.
Age in
years

Age in years

Age in years

Age in years

Age in years

Age in years

4.5
2.5
3
6

2. What is the total number of animals you sampled?
Should equal the number of ages listed above.............................................................. ________ head

For the following, write in responses. If zero or none, write in 0. If you can not answer a
question or it is not applicable, please note the reason why in the margin.
3. In the pen/area these samples were taken, how many:
a.

unweaned kids are present? .............................................................................. __________ head

b.

weaned kids 4 months to 1 year of age are present? ........................................ __________ head

c.

goats 2 years of age or greater are present? ...................................................... __________ head

Total animals in area .................................................................................................. __________ total
4. What breed of goats were sampled (Check all that apply).

Alpine
Angora
Boer
Kiko

La Mancha
Nubian
Oberhasli
Pygmy Goat

Saanen
Spanish
Tennessee Fainting
Toggenburg

… Other breed or cross
SPECIFY:
_______________

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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-XX. The time required to complete this information collection is estimated to average 1 hour
per response, including the time to review instructions, search existing data resources, gather the data needed, and complete
and review the information collected.

NAHMS-221
Nov 2008

5. How were the goats sampled selected?
a. Used famacha card ...........................................................................................

†1 Yes

†3 No

b.

Animal was symptomatic (e.g. had diarrhea) .....................................................

†1 Yes

†3 No

c.

Other specify: ________________________________ .....................................

†1 Yes

†3 No

†1 Yes †3 No
6. Before today, have these goats EVER been treated with a dewormer?........................
IF YES, what date were they last treated? (Explain in margin if you don’t know.). ................. ___________ mm/dd/yy

IF YES, using the Dewormer Reference List on the back of the Collection
Instruction Sheet, what was the name and code number for the product used?
Product name:________________________________ code from list: __________
If a second product was used at the same time, what was the name and code?
Product name:________________________________ code from list: __________
7. Which best describes the management of the sampled goats during the past 30 days?
†1 Open range (large unfenced acreage)
†2 Fenced range (large fenced acreage)
†3 Fenced farm (cultivated pasture or browse)
†4 Dry lot (pen which does not allow grazing and is not meant for
finishing goats on a high-energy diet for slaughter)
†5 Other (specify: ______________________________________)