Get Pdf Adverse Event Report Form - Aphis - Aphis Usda

This guide provides a comprehensive overview of how to accurately fill out the Pdf Adverse Event Report Form from the APHIS of the USDA. By following these steps, users can ensure that they provide all necessary information efficiently and accurately.

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by providing product information. List all immunobiological products used, including the brand name or generic name, U.S. veterinary license number or manufacturer name, serial (lot) number, and type of product.
3. Specify how each product was administered. Fill in details such as the dose, route, individual administering the product, site, needle size, date reconstituted, and the exact date of product use.
4. In the event information section, provide a detailed event description in a concise paragraph and select the type of event from the provided options. Indicate the onset time and the attending veterinarian’s suspicion level regarding whether the product caused the event.
5. Complete the outcome field by selecting one option that best describes the result of the event.
6. Enter the animal information, which includes case identification number, species, breed, sex, age, group size, neutering status, and details on how many individuals were affected, vaccinated, or deceased.
7. Provide the history and environment for the animal, which includes any relevant acquisition, vaccination, medical histories, and environmental factors.
8. In the personal information section, fill out the details for both the veterinarian and the owner, including names, addresses, phone numbers, and email addresses.
9. Confirm whether this event has been reported to the manufacturers and provide the submitter's first and last names, phone number, today's date, and their relationship to the animal.
10. Finally, review all entered information for accuracy, ensure all required fields are completed, and proceed to save changes, download, print, or share the form as needed.

Start completing the Pdf Adverse Event Report Form online now to ensure all necessary information is submitted accurately.