Vs 5-19b Flock Inspection and Epidemiology Report Flock Inspectio

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UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE VETERINARY SERVICES			FLOCK INSPECTION AND EPIDEMIOLOGY REPORT Flock Inspection for Complete Export Monitored Status In the Scrapie Flock Certification Program
Flock ID		Owner Name and Address			Flock Location if Different
PIN
Telephone
Inspector					Inspector ID		County
Inspection Date					Latitude		Longitude
Type of Flock __________ Purebred __________ Commercial __________ Feeder __________ Other __________________					SHEEP ­­­­­	INVENTORY Adult Males Adult Females Yearling Males Yearling Females Female Lambs/Kids Male Lambs/Kids Castrated Males Total			GOATS
Veterinary Practitioner Name
Species		Predominant Breed
Yes	NO	INSPECTION CHECKLIST
		Sheep and goats inspected and found free of clinical signs of scrapie.
		Sheep and goats inspected and those over 1 year of age are officially identified.
		Discussed procedure for reporting of both scrapie suspect animals and animals found dead, and the submission of samples.
WRITTEN OR COMPUTER RECORDS REVIEWED AND TRACK THE FOLLOWING INFORMATION?
		Official and Secondary Identification Type of official ID_____________________
		Sex and Breed.
		Progeny Official and Secondary identification and Sex.
		Date of Birth or Acquisition.
		Flock of Origin for purchased animals.
		Sire and Dams official and secondary identification.
		Source of animals added since last inspection.
		Purchased addition (name, date, and address of previous owner, status in SFCP).
		Purpose, reason, date, and buyer name and address for animals which are sold. Are all assumed to have been removed because they died? If not, should the other option(s) be noted?
		Disposition of removed animals: died, date, and cause, any practitioner diagnosis, if done.
		Purpose, reason, date, and buyer’s name and address for animals which are sold.
		Records of sheep and goats sold as breeding animals and official ID applied and records of any other sheep and goats sold or disposed of.
HAVE ANY OF THE FOLLOWING ACTIVITIES OCCURRED OVER THE LAST YEAR?
		Commingling of sheep with another producer’s sheep.
		Purchase of does/ewes from another producer.
		Purchase of bucks/rams from another producer.
		Use of semen and embryos.
		Copy of Flock Inventory Attached.
Comments:
FLOCK OWNER SIGNATURE				INSPECTOR SIGNATURE

VS 5-19B

MAR 2010