D Dubois, IN 46527-9666 812-678-3401 Fax 812-678-3412 COMPANY Company Veterinarian/ Contact Person Vet Phone ADDL USE ONLY COMMERCIAL POULTRY INCIDENT ADDL USE ONLY ARRIVED Chilled/Cold Pack Frozen Ambient Dry Ice CONDITION Good Broke/Leaked ADDL USE ONLY INITIALS: S T OF SW.
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How to fill out the Purdue University ADDL CF 901 online
The Purdue University ADDL CF 901 form is essential for reporting poultry disease incidents. This guide provides clear, step-by-step instructions to assist users in accurately completing the form online.
Follow the steps to fill out the Purdue University ADDL CF 901 form effectively.
- Press the ‘Get Form’ button to access the ADDL CF 901 document and open it in your preferred editing environment.
- Begin by entering the company's name and relevant contact information in the designated fields. Specify the company veterinarian or contact person's name and phone number for communication purposes.
- Proceed to the ADDL use only section. This section includes checking the boxes for the arrival condition of the samples, such as 'Chilled/Cold Pack', 'Frozen', or 'Ambient'.
- Indicate the condition of the samples by selecting 'Good' or 'Broke/Leaked' in the appropriate box.
- Fill out the information related to the poultry species being submitted by checking boxes for 'Layer', 'Turkey', 'Duck', 'Broiler', 'Breeder', or 'Other'. Specify the age of the flock in days, weeks, or months.
- Enter the flock/animal site premise ID number as required, using the provided barcoded label.
- Select the tests requested for the samples by checking the boxes for options such as 'Avian Influenza PCR' or 'Newcastle Disease PCR'.
- Identify the incident area or zone by choosing options such as 'Control Area', 'Surveillance Zone', or 'Free Zone'.
- Complete the house/barn ID, the number of tubes per barn/house, and the flock number or ID in the designated spaces.
- Select the reason for submission by checking one or more applicable boxes, such as 'Mortality/Morbidity Event' or 'Surveillance'.
- If applicable, list the tube numbers or sample sites in the provided section for post cleaning and disinfection (C&D) submissions.
- Indicate the samples submitted by checking the relevant options for oropharyngeal, cloacal, or environmental swabs.
- If you have more samples, continue on page 2 by providing the additional details as needed.
- Review all entered information for accuracy and completeness. Once satisfied, save your changes, then download, print, or share the completed form as necessary.
Complete the Purdue University ADDL CF 901 form online today to ensure timely and effective management of poultry disease incidents.
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