VS 21-302 Health Management on U.S. Feedlots 2020 Consent to Conta

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 0579-0079. The
time required to complete this information collection is estimated to average 10 minutes per
response, including the time to review instructions, search existing data resources, gather the data
needed, and complete and review the information collected.
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES
NATIONAL ANIMAL HEALTH MONITORING SYSTEM
2150 CENTRE AVE, BLDG B
FORT COLLINS, CO 80526

For release of information for:

OMB Approved
0579-0079
EXP: XX/20XX

HEALTH MANAGEMENT ON U.S.
FEEDLOTS 2020 CONSENT TO
CONTACT
EPAID:

(Consenting Operator: Hereafter referred to as YOU)
The USDA’s Animal and Plant Health Inspection Service’s (APHIS) National Animal Health Monitoring System (NAHMS) is
conducting a study of U.S. feedlot operations with a capacity of 50 or more cattle. NAHMS studies are voluntary and
nonregulatory. This study will take an in-depth look at U.S. feedlots and provide new and valuable information regarding animal
health and management practices in the U.S. feedlot industry. To initiate the study, a sample was selected from the confidential
list of operations maintained by USDA’s National Agricultural Statistics Service (NASS). Your feedlot was selected for
participation and will represent a number of unselected feedlots.
By signing this Consent Form, you are agreeing to allow USDA–NASS staff to provide the following information to the
State NAHMS Coordinator, who is employed by USDA–APHIS: your name, address, phone number, email address,
inventory, and operation type. All data from this questionnaire will be shared with NAHMS state coordinators.
The NAHMS Coordinator will share this information with a Federal or State veterinary medical officer (VMO), who will contact
you to administer a phase II questionnaire. Only the Federal or State VMOs collecting the data know the identity of study
participants.
Confidentiality of your data is crucially important to us. No name or contact information will be associated with
individual data, and no data will be reported in a way that could reveal the identity of a participant. Data are presented
only in aggregated summaries.
When you are contacted by a Federal or State VMO and asked to participate in the study, you are free to accept or decline
participation at that time. A copy of the questionnaire that will be administered when you’re visited by the Federal or State VMO
can be found at: www.aphis.usda.gov/nahms. If you have been selected but have not been contacted or if you have
questions regarding the study, please call: (866) 907-8190.
1.

Operation Address: _____________________________________________ 2. Operation phone #: _________________

3.

Operation Email Address: ____________________________________________________________________________

4.

Notes regarding the operation, (e.g. animals located in different state, changes to address or contact information):

Signature of Consenting Operator:

Date:

Signature of NASDA/NASS Enumerator:

Date:

VS Form 21-302
September 2020

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