Get Az Adhs Rabies Risk Assessment & Laboratory Submission Form 2021-2025

This guide provides step-by-step instructions for completing the AZ ADHS Rabies Risk Assessment & Laboratory Submission Form online. By following these instructions, users can ensure that they fill out the necessary information accurately and effectively.

Follow the steps to complete the form with ease.

1. Click ‘Get Form’ button to access the rabies risk assessment form and open it in your chosen editor.
2. Begin by filling out your contact details in the 'Submitter' section. Include your agency name, contact name, address, city, state, zip code, phone number, and email.
3. Select your role from the options provided in the 'Submitter' section, such as veterinarian, animal control officer, police officer, or other.
4. In the 'Suspected Rabid Animal' section, detail the type and species of the animal. Enter the onset date of symptoms, date collected, approximate age, gender, vaccination status, and mortality status.
5. Complete the 'Human Exposure' section by entering the animal ID, reason for submitting, quarantine status, and whether the exposure was provoked, unprovoked, or unknown.
6. If neurological symptoms are present, indicate 'Yes' and check off any symptoms that apply.
7. Fill in details regarding the exposure, such as the exposure date, number of humans exposed, type and location of exposure, and contact information for the exposed party.
8. For domestic animal exposure, similarly provide the exposure date, number of animals exposed, and owner's contact information.
9. Provide the location of the exposure, including latitude and longitude if available, as well as additional information about the location.
10. In the final sections, describe the human/domestic animal exposure in detail, confirm county and state approvals for the sample submission, and include any notes as necessary.
11. Once the form is complete, email your submission to vbzd@azdhs.gov for approval prior to specimen shipping.
12. If approved, send the specimen to the Arizona State Public Health Laboratory along with any required documentation.

Complete your paperwork online today to ensure a timely response!