NAHMS-218 Goat 2009 General Producer Agreement

National Animal Health
Monitoring System

Goat 2009
General
Producer Agreement

Animal and
Plant Health
Inspection
Service
Veterinary
Services

2150 Centre Ave, Bldg B
Fort Collins, CO 80526
Form Approved
OMB Number 0579-xxxx
Expires: xxxx

The U.S. Department of Agriculture's Animal and Plant Health Inspection Service (APHIS), the State of _______________, and
the Producer hereby enter into this National Animal Health Monitoring System (NAHMS) Goat 2009 Study PRODUCER
AGREEMENT, the terms of which are set forth below.
1.

APHIS and/or the State of __________________ will provide personnel who will be referred to as the Data Collector. The
Data Collector and the Producer will participate together in implementing a statistically valid NAHMS study for determining
national estimates of goat-health practices and for compiling health information to enhance goat production. The Data
Collector and the Producer will complete one personal interview.

2.

The Producer will assist APHIS by providing accurate information regarding goat-health and management practices
related to the study objectives. The Producer retains the right to refuse any questions deemed inappropriate.

3.

The Data Collector will keep the origin of the data confidential by recording the data with the Producer’s unique code number
only. The Data Collector will not keep any key to the code after the completion of the study. The Data Collector and all other
project personnel acknowledge that the Producer is providing information and samples that he/she does not customarily share
and is providing it with the expectation that it will not be made public. The one exception to data confidentiality is the
suspicion or diagnosis of a dangerously contagious, infectious, or exotic disease foreign to the U.S. on the Producer’s
premises (e.g., foot-and-mouth disease), in which case further investigation and possible action may occur.

4.

Data collected by the Data Collector will not be used for regulatory purposes. However, information on a Producer’s animals
revealed from sources unrelated to the Goat 2009 study, such as testing and inspection for movement or sale of animals or
tracebacks on testing done at slaughter, may cause regulatory action to be initiated by the State or APHIS.

5.

APHIS may publish, or authorize others to publish, the aggregate (summary) findings acquired from NAHMS for the benefit
of the goat industry, allied private industry, and other interested groups, but will ensure that the identity of the Producer is
withheld. APHIS may not publish, or authorize others to publish, individual responses. APHIS may perform additional testing,
or authorize others to perform additional testing of samples collected through the study, for the benefit of the goat industry,
but will ensure that the identity of the Producer is withheld.

6.

After completion of data reporting by the Producer, APHIS will provide the Producer with several reports containing
summary results from all participating Producers. The Producer can obtain any further information available from this study
by accessing the NAHMS Web site or subscribing to the NAHMS goat mailing list.

7.

The Producer will complete a brief evaluation of the Goat 2009 study, the results of which will be used to assist APHIS in the
design and implementation of future NAHMS surveys.

8.

Any changes to or waivers of the terms of this PRODUCER AGREEMENT shall be binding on APHIS and the STATE of
___________________ and the Producer only if they are put in writing by each party.

9.

The effective data collection period of this PRODUCER AGREEMENT shall begin with today’s date of ____/____/____ and
end no later than December 15, 2009.

Continued on next page with biological testing.

/date
VS Employee, U.S. Department of Agriculture, APHIS
OR _____________ Department of Agriculture

/date
Producer or authorized representative

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-xxx. The time required to complete this information collection is estimated to average 0.5 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-218
NOV 2008

10. Biologic Sampling by Data Collector –

I AGREE to
participate if
selected

I DO NOT
want to be
considered

(Producer to initial appropriate column.)

____________

___________

Environmental Samples
Six samples of pooled manure will be collected from various locations
on the goat operation. The samples will be tested for Johne’s and results
will be returned to the Producer.

____________

___________

a. Blood
About 10 ml of blood collected from no more than 51 goats will be
tested for Mycobacterium paratuberculosis (Johne’s) and caprine
arthritis encephalitis (CAE). These results will be returned to the
Producer.
Sera will be banked for possible future testing. See Item 5 on previous
page.
b.

(Producer to initial appropriate column.)

Î Item 11 may need to be completed after the Data Collector and Producer review the Info Sheets and
special Agreements.
11. Biologic Sampling by Producer –
a. Fecal
One pooled sample of fresh fecal materials will be
collected from up to 20 goats. Samples will be tested for
specific food-safety pathogens. A subset of the samples
will be tested for anthelmintic reaction.
Producer will need to sign the Supplemental Producer
Agreement to participate.

Yes, and I signed I’m interested,
the supplemental but want more
agreement
time to consider

No, I do not
want to
participate

_________

________

________

Yes, and I signed
the supplemental
agreement

I’m interested,
but want more
time to consider

No, I do not
want to
participate

_________

________

________

Yes, and I signed
the supplemental
agreement

I’m interested,
but want more
time to consider

No, I do not
want to
participate

_________

________

________

(Producer to initial appropriate column.)

b.

Scabs
Scabs from up to 10 goats suspected of having soremouth
will be collected. Samples will be tested for soremouth,
and the Producer will receive the result.
Producer will need to sign the Supplemental Producer
Agreement to participate.
(Producer to initial appropriate column.)

c.

Bulk Milk
One bulk milk sample will be collected from dairy
operations. The sample will be tested for various
pathogens and bacteria such as E. coli, Staph, Strep, and
Salmonella. Producer will receive the results.
Producer will need to sign the Supplemental Producer
Agreement to participate.
(Producer to initial appropriate column.)

National Animal Health Monitoring
System

Goat 2009

Animal and
Plant Health
Inspection
Service

2150 Centre Ave, Bldg B #2E7
Fort Collins, CO 80526

Supplemental
Producer Agreement

Veterinary
Services

Contact: Judy Rodriguez
970 494 7255
[email protected]

The U.S. Department of Agriculture's Animal and Plant Health Inspection Service (APHIS), the State of _______________, and
the Producer hereby enter into this National Animal Health Monitoring System (NAHMS) Goat 2009 Supplement Producer
Agreement, the terms of which are set forth below.
1.

The Producer must perform the following:
a. Collect, store, and ship the biologic samples as instructed.
b. Complete the appropriate submission forms, mail a copy to the NAHMS staff, and send a copy with the samples to the
appropriate laboratory.
c. Use Federal Express to ship samples to the laboratory.

2.

NAHMS will provide the Producer all of the appropriate collection materials needed to complete the sampling including
preaddressed/prepaid FedEx airbills, business-reply envelopes, ice packs, sample bags, boxes, and instructions.

3.

The Producer allows his/her name, shipping address (and mailing if different), and phone number to be given to Judy
Rodriguez on the NAHMS staff for the purpose of sending/expediting the collection materials (kit) and testing results directly
to the Producer and to contact the Producer if a problem arises. Judy will maintain this information in a confidential manner,
use only for the purposes described, and purge the information after results are returned to the Producer.
Operation Number: ______________________ (VS Data Collector – please enter the 4-digit farm ID)
Producer name:

____________________________

Best contact (e-mail or phone #): _________________________

Shipping address: ____________________________

Postal/mailing address: _________________________

(not PO Box)

4.

____________________________

City, State, Zip Code: _________________________

By checking the appropriate box and signing below, the Producer agrees to participate in one or more of the Producercollected biologic sampling.

… Fecal Samples – Your signature indicates that you want to participate in the Fecal Sampling and will
collect the samples as instructed.
/

date

Producer or authorized representative

… Scab – Your signature indicates that you want to participate in the Scab Sampling and will collect the
samples as instructed.
/

date

Producer or authorized representative

… Bulk Milk – Your signature indicates that you want to participate in the Bulk Milk Sampling and will
collect the samples as instructed.
/

date

Producer or authorized representative
Data Collector – If the Producer wants more time to decide, leave this agreement and instruct the Producer to sign, date, and send to
NAHMS using the provided envelope. The Producer should contact Judy Rodriguez if he/she doesn’t hear from her within 10 days to ensure
that form wasn’t lost in mail. If signed during your visit, mail Judy the original and email her that it is coming. A copy is left with the
Producer and a copy is sent to your Coordinator.