VS 5-29 A Scrapie Test Record - Continuation Sheet

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 0579-0101. The time required to complete this information collection is estimated to average .3 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

FLOCK OWNER'S NAME - LAST

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SCRAPIE TEST RECORD
CONTINUATION SHEET
Complete all entries on VS Form 5-29 before using this form.
FIRST

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NOTE: Sample numbers on specimens must be the same as listed on
this form.

Remarks:

VS FORM 5-29A
MAY 2023

INITIAL

FLOCK ID

DATE
COLLECTED

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PAGE NO.

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OMB Approved
0579-0101
Exp 05/2027

VETERINARIAN

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Rectal Biopsy
Sample Loc
(circle one #)1

animals that may be sampled multiple times, e.g. SFCP or
Exposed animals, circle the quadrant number where the rectal biopsy
sample was taken for each animal.