NAHMS-225 Goat 2009 Johne's Follow Up Blood Collection Record

National Animal Health
Monitoring System

Goat 2009
Johne’s Follow Up
Blood Collection Record

Animal and
Plant Health
Inspection
Service
Veterinary
Services

2150 Centre Ave, Bldg B
Fort Collins, CO 80526
Form Approved
OMB Number 0579-???
Expiration date: xxx

Instructions:
1) Sample only the goats listed below.
2) Collect 1 tube of blood using the provided 18 gauge 1-inch vacutainer needles and tubes.
3) Write the State, Operation, Kit, and Animal ID on the tube label.
4) Record the tube number next to the Goat ID listed below.
5) Ship with ice packs to the laboratory within 24 hours. Include the yellow copy of this form with
the samples. Send the original to NAHMS and the pink copy to your Coordinator.
State FIPS:

Operation #:

2 digits

4 digits

Tube #
from label

Goat ID

Date:

Kit #:

mm/dd/yy

Printed on labels

Body Score
1 = Thin, 2 = Normal 3 = Fat
…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

…1 T

…2 N

…3 F

Comments regarding goat
including any clinical signs

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-XXXX. The time required to complete this information collection is estimated to average 1.0
hour per response, including the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information collected.

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NAHMS-225
Nov 2008