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NVAP Reference Guide: Appendix D:

Forms

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NVAP Reference Guide: Table of Contents

Questions, Comments, or Technical Issues?

NVAP Error Report Form

Preface

Introduction

Control and Eradication

Brucellosis

Johne’s Disease

Pseudorabies (PRV)

Tuberculosis

Transmissible Spongiform Encephalopathies

Scrapie

Bovine Spongiform Encephalopathy (BSE)

Chronic Wasting Disease (CWD)

Poultry
National Poultry Improvement Plan (NPIP)

Avian Influenza (AI)

Exotic Newcastle disease (END)

Equine Disease

Aquatic Animal

Aquatic Animal National Health Plan

Aquatic Animal Health Activities

Animal Health Emergency Management

Animal Health Emergency Management

Emergency Response Structure

National Response Framework (NRF)

National Incident Management System (NIMS)

National Animal Health Emergency Management System (NAHEMS)

Foreign Animal Disease Preparedness and Response Plan (FAD PReP)

FAD Recognition and Initial Response

National Animal Health Emergency Response Corps (NAHERC)

Notifiable Diseases and Conditions

WOAH and International Standards

Cleaning and Disinfection

Importance of Cleaning & Disinfection

Cleaning

Disinfection

Regulation of Disinfectants

Safety

Disease Surveillance

Laboratory Submissions

Animal Movement

Interstate Regulations

Interstate Movement of Cattle, Horses, Swine, Sheep and Goats

Issuing Interstate Animal Movement Documents

International Animal Movement

Issuing International Health Certificates (IHCs) for Live Animal Movement

Common Problems Observed on Certificates for Live Animal Movement
Animal Identification 

Animal Identification

Cattle Identification

Swine Identification

Equine Identification

Sheep and Goat Identification

Fowl Identification

Compliance and Regulations

Appendix

A: 9 CFR PARTS 160, 161, and 162

B: APHIS VS District Offices

C: State Animal Health Officials

D: Forms

E: Other Organizational Information with Contact Points

F: Web Sites

G: Equine Teeth and Aging

Appendix D – Forms and Instructions for Completing Them (2.02

MB)

VS Form 1–27, Permit for Movement of Animals, 16-3

VS Form 1–27A, Permit for Movement of Animals, Continuation Sheet, 16-4

VS Form 4–24, Brucellosis Vaccination Record, Short Form, 16-7

VS Form 4–26, Brucellosis Vaccination Record, Short Form, 16-9

VS Form 4–33, Brucellosis Test Record, 16-12

VS Form 4–33A, Brucellosis Test Record, Continuation Sheet, 16-13

VS Form 4–54, Brucellosis Test Record, Market Cattle Testing Program, 16-15

VS Form 6–22, Tuberculosis Test Record, 16-17

VS Form 6-22A, Tuberculosis Infected Herd, 16-18
VS Form 6-22B, Tuberculosis Test Record, Continuation Sheet, 16-19

VS Form 10–4, Specimen Submission, 16-24

VS Form 10-4A, Specimen Submission, Continuation Sheet, 16-26

VS Form 10–12, Equine Infectious Anemia Supplemental Investigation, 16-29

VS Form 10–13, Owner Shipper Certificate, 16-33

VS Form 10–13A, Owner Shipper Certificate, Continuation Sheet, 16-35

VS Form 17–6, Certificate for Poultry or Hatching Eggs for Export, 16-37

VS Form 17–140, United States Origin Health Certificate, 16-39

VS Form 17–140A, United States Origin Health Certificate, Continuation Sheet, 16-41

APHIS Form 7001, United States Interstate and International Certificate of Health

Examination for Small Animals, August 1994, 16-43

APHIS Form 7001, United States Interstate and International Certificate of Health

Examination for Small Animals, November 2010, 16-44

APHIS Form 7001A, United States Interstate and International Certificate of Health

Examination for Small Animals, Continuation Sheet, September 1993, 16-45

VS Form 17-145, United States Origin Health Certificate for the Export of Horses

From the United States to Canada, 16-48

16-1

All pre-numbered APHIS and VS forms are accountable documents and failure to

provide security for the forms is a violation of your accredited status.  

If you have any questions about completing or ordering these forms, you can

contact your local APHIS-VS Area Offices or NIES Service Center

VS Form 10-4 Specimen Submission form for NVSL is not pre-numbered and may be

completed on line, printed out, and included with your specimens sent to NVSL.  The

electronic form is available at: 
Veterinary Services Process Streamlining (VSPS) where many of these forms, as well

as some of the international official health certificates of foreign destination

countries, are available on line. The VS form 10-11, Equine Infectious Anemia

Laboratory Test, is already available in the VSPS. The form can be completed on line

in VSPS and transmitted electronically to the laboratories that have linked up with

VSPS. The electronic EIA test record has the capability to upload digital photos of the

horse.