One Health - RCA (15)

• Version # 15: May 9th, 2022

• Doc ID: 4.a.ii.2.a

• Date of RCA Submission

  Date

• Farm State

  Maryland

  Delaware

  Virginia

  North Carolina

  South Carolina

• Farm Name

  Select

• House Number(s) (if listing multiple houses, include all house number in this section separated by commas)

• Date Placed

  Date

• Root Cause

  Select Dermatitis Necrotic Enteritis/Cocci Airsac/Polyserositis On-Farm Management Uneven Chick Mortality Other

  • Dermatitis
  • Necrotic Enteritis/Cocci
  • Airsac/Polyserositis
  • On-Farm Management
  • Uneven
  • Chick Mortality
  • Other

• Script Requested?

  Script Requested

  No Script Requested

Requirements Statement: -For week 1 (0-7 days of age) action threshold is >5/1000/day for 2 consecutive days, or 10/1000 for 1 day. -For week 2-harvest (8 days-harvest) action threshold is >3/1000/day for 2 consecutive days, or > 5/1000 for 1 day.

Chick Health

• Increments of "0.1" - round to the tenth decimal place, are only accepted. (As Needed)

• EX: 2.3 is okay, but 2.28 is NOT accepted.

• Is This First Week Mortality?

  Yes

  No

• Is this delayed reporting?

  Yes

  No

• Reason for Delay

  Grower

  Flock Supervisor

• Reporting not immediate, as required by contract

• Re-trained for Non-conformance

• Other:

• Describe:

• Describe:

  Select Mobile / I-auditor platform issue Personal Issue

  • Mobile / I-auditor platform issue
  • Personal Issue

• Is this report delayed by 7 days or more

  Yes

  No

• How many days is the report delayed?

• Attach photos of the mortality charts for each house being reported

  Media

• Are you reporting multiple houses?

  Yes

  No

• House Number

• Number of Birds Placed in House

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Are you reporting multiple houses?

  Yes

  No

• House Number

• Number of Birds Placed in House

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of birds placed in the house

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Chick Quality, Select from the Following:

  Select Infectious Disease (Omphalitis, Asper, etc.) Non-Infectious Disease (Dehydration, Red Hocks, Navel) Other

  • Infectious Disease (Omphalitis, Asper, etc.)
  • Non-Infectious Disease (Dehydration, Red Hocks, Navel)
  • Other

• Describe Challenge:

• Describe the On-Farm Correction:

• Was an On-Farm Necropsy Performed?

  Yes

  No

• Add Photos

  Media

• Were birds submitted to a Laboratory?

  Yes

  No

• Was a Feed Sample Submitted?

  Yes

  No

Bird Health

• Is this delayed reporting?

  Yes

  No

• Reason for Delay

  Grower

  Flock Supervisor

• Reporting not immediate, as required by contract

• Re-trained for Non-conformance

• Other:

• Describe:

• Describe:

  Select Mobile / I-auditor platform issue Personal Issue

  • Mobile / I-auditor platform issue
  • Personal Issue

• Is this report delayed by 7 days or more

  Yes

  No

• How many days is the report delayed?

• Attach photos of the mortality charts for each house being reported

  Media

• Are you reporting multiple houses?

  Yes

  No

• House Number

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• House Number

• Number of Birds Placed:

• Age of birds at time of mortality increase:

• Mortality Day 1 (x/1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Are you reporting multiple houses?

  Yes

  No

• House Number

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Do you wish to report another house?

  Yes

  No

• House number?

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• House Number

• Number of Birds Placed:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

• Are birds greater than 21 days of age?

  Yes

  No

• Is the mortality (deads, NOT culls) greater than 3/1000 for 2 consecutive days or 5/1000 for 1 day?

  Yes

  No

• Will or have birds or AI swabs been submitted to the lab in response?

  Yes

  No

• Select On-Farm Issues, where applicable

  Select Water Temperature Extremes Air Quality Feed Lights Catch Mortality Other

  • Water
  • Temperature Extremes
  • Air Quality
  • Feed
  • Lights
  • Catch Mortality
  • Other

• Describe the Water Issue:

• Describe the Temperature Issue:

• Describe the Air Quality Issue:

• Describe the Feed Issue:

• Describe the Lighting Issue:

• Select the Issue:

  Select Suffocation Culling Other

  • Suffocation
  • Culling
  • Other

• Describe:

  Yes

  No

• Describe the Issue:

  Yes

  No

• Select an Infection Area:

  Select Guts Respiratory Lameness Other

  • Guts
  • Respiratory
  • Lameness
  • Other

• What is the gut challenge?

  Select Necrotic Enteritis Cocci RSS Other

  • Necrotic Enteritis
  • Cocci
  • RSS
  • Other

• Describe the challenge:

• What is the Respiratory Challenge?

  Select Airsac Vaccine Reaction ILT Polyserositis (Bacterial Infections in multiple organs) Pericarditis (Bacterial Infection around the heart) Other

  • Airsac
  • Vaccine Reaction
  • ILT
  • Polyserositis (Bacterial Infections in multiple organs)
  • Pericarditis (Bacterial Infection around the heart)
  • Other

• Describe the Challenge:

• What is the Lameness Challenge?

  Select Bacteria (FHN) (Synovitis) Reovirus (Ruptured Tendons) Kinky Back Kick Stand Other

  • Bacteria (FHN) (Synovitis)
  • Reovirus (Ruptured Tendons)
  • Kinky Back
  • Kick Stand
  • Other

• Describe the Challenge:

• What is the Challenge?

  Select Dermatitis Mixed Uneven Eye Ulcers(AB Eyes) Spike Feed Knockdown Unknown Other

  • Dermatitis
  • Mixed
  • Uneven
  • Eye Ulcers(AB Eyes)
  • Spike
  • Feed Knockdown
  • Unknown
  • Other

• Describe the Challenge:

• Describe the Challenge:

• On-Farm Correction:

• Was an On-Farm Necropsy performed?

  Yes

  No

• Add Photos

  Media

• Have birds/samples been submitted to a Laboratory?

  Yes

  No

• Have AI Swabs been submitted?

  Yes

  No

• Was a Feed Sample Submitted?

  Yes

  No

• Is an Anitbiotic Treatment Needed?

  Yes

  No

• Grower Number:

Script Request

• House Number:

• Number of Birds Placed:

• Bird Age:

• What Antibiotic is being used?

  Select Penicillin Tetracycline Lincomycin Tylosin BMD Sulfa (SDM, Sulmet) Other

  • Penicillin
  • Tetracycline
  • Lincomycin
  • Tylosin
  • BMD
  • Sulfa (SDM, Sulmet)
  • Other

• What antibiotic is being used?

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Has a written and/or verbal instruction on administering medication occurred?

  Yes

  No

• Date communicated

  Date

• Management Steps Needed

  Select Cull Affected Birds Alternative Management

  • Cull Affected Birds
  • Alternative Management

• Describe the Alternative Management:

• Further actions taken:

Flock Supervisor Sign-off and Date

• Please sign when complete

  Sign

• Non-Antibiotic treatments must be run according to Label Directions unless instructed otherwise by a Mountaire Veterinarian

• What Non-Antibiotic treatment is being used?

  Select Amprol Copper Sulfate Manage / Maintain Ioprin / Asperdine Activo CID Clean Water Acidifier (PWT, SB Plus, Amacil) Celmanax Lumance Other

  • Amprol
  • Copper Sulfate
  • Manage / Maintain
  • Ioprin / Asperdine
  • Activo
  • CID Clean
  • Water Acidifier (PWT, SB Plus, Amacil)
  • Celmanax
  • Lumance
  • Other

• Describe the Treatment:

Flock Supervisor Sign-off and Date

• Please sign when complete

  Sign
Script Request

• House Number:

• Number of Birds Placed:

• Bird Age:

• What Antibiotic is being used?

  Select Penicillin Tetracycline Lincomycin Tylosin BMD Sulfa (SDM, Sulmet) Other

  • Penicillin
  • Tetracycline
  • Lincomycin
  • Tylosin
  • BMD
  • Sulfa (SDM, Sulmet)
  • Other

• What antibiotic is being used?

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Pack/Jug size:

• #Pack:Gallon or Oz./G

• Total Number of Packs:

• Days to Treat:

• Was the house treated last flock?

  Yes

  No

• Acceptable Values in this section are: 2, 3, or 4

• For example: House X was treated the last 2 flocks- making this the 3rd consecutive treatment. The next answer would be 3

• What consecutive treatment is this house on?

  2

  3

  4

• Management Steps Needed

  Select Cull Affected Birds Alternative Management

  • Cull Affected Birds
  • Alternative Management

• Describe the Alternative Management:

• Further actions taken:

• Has a written and/or verbal instruction on administering medication occurred?

  Yes

  No

• Date communicated

  Date

Flock Supervisor Sign-off and Date

• Please sign when complete

  Sign

Reviewing Veterinarian Signature

• Select VET

  Select

• Delayed Review by Veterinarian

  Yes

  No

• iAuditor Platform or Mobile Issue

• Other

• Vet Review Date:

  Sign

Prescription

• For Vet Use ONLY

• Has the Script been completed? (NOTE: Farm Name, House #, and Date match title of RCA)

• Notes: