VS 5-29A 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.

VETERINARY SERVICES
FLOCK OWNER’S NAME – LAST

Specimen #

FLOCK ID

SCRAPIE TEST RECORD
CONTINUATION SHEET

U.S. DEPARTMENT OF AGRICULTURE ANIMAL
AND PLANT HEALTH INSPECTION SERVICE

of

Complete all entries on VS Form 5-29 before using this form.

FIRST

Official ID Numbers (s)

INITIAL

Other ID Numbers

PAGE NO.

DATE
COLLECTED

Designation
(pos, sus,
exp, me, n/a)

OMB Approved
0579-0101
Exp 05/2027

VETERINARIAN

Age

Sex
(m, f, cm)

Breed
(If unkn,
face)

Rectal Biopsy
Sample Loc
(Type one #) 1

@
@
@
@
@
@
@
@
@
4

4

4

4

4

4

4

4

4

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

VS 5-29A
JAN 2025

1

For animals that may be sampled multiple times, e.g. SFCP or Exposed
animals, type the quadrant number in the space next to the diagram.