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OMB Approved 0579-0036 0579-0093 |
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The Animal Welfare Regulations, Title 9, Subchapter A, Part II, Subpart C, Section 2.33 and Subpart D, Section 2.40 require a Program of Veterinary Care. |
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UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE
Animal care (Program of Veterinary Care for Research Facilities or Exhibitors/Dealers) |
OFFICE Use Only |
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Date received: |
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Section I. A Program of Veterinary Care (PVC) has been established Between: |
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a. licensee/registrant |
b. veterinarian |
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1. Name:
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1. Name: |
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2. business name:
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2. clinic Name: |
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3. USDA License/Registration number:
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3. state License number: |
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4. Mailing address:
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4. business address: |
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5. City, StatE, and Zip Code:
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5. City, StatE, and Zip Code: |
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6. telephone number (Home): |
telephone number (Business):
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6. telephone number (Business): |
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This is a form that may be used for the Program of Veterinary Care. Also, this form may be used as a guideline for the written Program of Veterinary Care, as required.
The attending veterinarian shall establish, maintain, and supervise programs of disease control and prevention, pest and parasite control, pre-procedural and post-procedural care, nutrition, euthanasia, and adequate veterinary care for all animals on the premises of the licensee/registrant. A written program of adequate veterinary care between the licensee/registrant and the doctor of veterinary medicine shall be established and reviewed on an annual basis. By law, such programs must include regularly scheduled visits to the premises by the veterinarian. Scheduled visits are required to monitor animal health and husbandry.
Pages or blocks which do not apply to the facility should be marked N/A. If the space provided is not adequate for a specific topic, additional sheets may be added. Please indicate Section and Item Number.
I have read and completed this Program of Veterinary Care, and understand my responsibilities.
Regularly scheduled visits by the veterinarian will occur at the following frequency:
_________________________________________________ (minimum annual).
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c. signature of licensee/registrant:
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Date: |
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d. Signature of veterinarian:
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Date: |
APHIS 7002 Page 1 of 4
JUN 2011
check if n/a section ii. dogs and cats |
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A. vaccinations – specify the frequency of vaccination for THE following diseases: |
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Canine |
Feline |
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Parvovirus |
Juvenile |
Adult |
Panleuk |
Juvenile |
Adult |
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distemper |
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Resp. Viruses |
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Hepatitis |
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Rabies |
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Leptospirosis |
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OTHER (Specify) |
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RABIES |
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Bordetella |
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OTHER (Specify) |
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b. parasite control program – describe the frequency of sampling or treatment for the following: |
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1. ectoparasites (Fleas, Ticks, Mites, Lice, Flies):
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2. blood parasites (Heartworm, Babesia, Ehrlichia, Other):
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3. intestinal parasites (Fecals, Deworming):
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c. emergency care – describe provisions for emergency, weekend, and holiday care: |
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d. euthanasia |
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1. sick, diseased, injured, or lame animals shall be provided with veterinary care or euthanized. euthanasia will be in accordance with the avma recommendations and will be carried out by the following:
veterinarian Licensee/registrant
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2. method(s) of euthanasia: |
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e. additional program topics – the following topics have been discussed in the formulation of the program of veterinary care: |
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Congenital Conditions |
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Exercise Plan (Dogs) |
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Quarantine Conditions |
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Proper Handling of Biologics |
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Nutrition |
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Venereal Diseases |
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Anthelmintic Alternation |
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Pest Control and Product Safety |
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Other (Specify)__________________________________ |
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Proper Use of Analgesics and Sedatives |
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APHIS 7002 Page 2 of 4
JUN 2011
check if n/a section iIi. Wild and exotic animals |
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A. vaccinations – list The diseases for which vaccinations are performed and the frequency of the vaccinations (Enter N/A if not applicable): |
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Carnivores: |
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Hoofed stock: |
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Primates: |
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Elephants: |
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Marine mammals: |
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Other (Specify): |
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b. parasite control program – describe the frequency of sampling or treatment for the following: |
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1. ectoparasites (Fleas, Ticks, Mites, Lice, Flies):
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2. blood parasites:
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3. intestinal parasites:
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c. emergency care |
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1. describe provisions for emergency, weekend, and holiday care:
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2. describe capture and restraint method(s):
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d. euthanasia |
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1. sick, diseaseD, injured, or lame animals shall be provided with veterinary care or euthanized. euthanasia will be in accordance with the avma recommendations and will be carried out by the following:
veterinarian Licensee/registrant
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2. method(s) of euthanasia: |
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e. additional program topics – the following topics have been discussed in the formulation of the program of veterinary care: |
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Pest Control and Product Safety |
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Environment Enhancement (Primates) |
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Quarantine Procedures |
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Water Quality (Marine Mammals) |
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Zoonoses |
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Species-specific Behaviors |
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Other (Specify) __________________________ |
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Proper Storage and Handling of Drugs and Biologics |
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Proper Use of Analgesics and Sedatives |
F. list the species Subjected to TB Testing, and the Frequency of Such TestS: |
APHIS 7002 Page 3 of 4
JUN 2011
check if n/a section iv. other warmblooded animals |
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A. Indicate species: |
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B. Vaccinations – list the diseases for which vaccinations are performed and the frequency of vaccinations (Enter N/A if not applicable): |
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C. parasite control program – describe the frequency of sampling or treatment for the following: |
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1. ectoparasites (Fleas, Ticks, Mites, Lice, Flies):
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2. internal parasites (Helminths, Coccidia, Other):
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D. emergency care – describe provisions for emergency, weekend, and holiday care: |
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E. euthanasia |
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1. sick, diseased, injured, or lame animals shall be provided with veterinary care or euthanized, euthanasia will be in accordance with the avma recommendations and will be carried out by the following:
veterinarian Licensee/registrant
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2. method(s) of euthanasia: |
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F. additional program topics – the following topics have been discussed in the formulation of the program of veterinary care: |
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Pasteurellosis |
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Species Separation |
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Pododermatitis |
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Malocclusion/Overgrown Incisors |
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Cannibalism |
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Pest Control and Product Safety |
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Wet Tail |
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Handling |
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Other (Specify)___________________________________________________________________ |
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__________________________________________________________________________ |
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APHIS 7002 Page 4 of 4
JUN 2011
File Type | application/msword |
File Title | According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond |
Author | Government User |
Last Modified By | Hardy, Kimberly A - APHIS |
File Modified | 2012-11-19 |
File Created | 2011-06-02 |