Investigation Background

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

Is This First Week Mortality?

Chick Quality (0-7 Days)
Select One Of The Following:

Infectious Disease (Omphalitis, Asper, etc...)

Non-Infectious Disease (Dehydration, Red Hocks, Navel)

Mixed

Other

Describe:

Mortality as x/1000

Increments of ".5" are only accepted. (As Needed)

EX: 2.5 is okay, but 2.56 is NOT accepted.

Today

Yesterday

2 Days Before

Comments (If Applicable)

Flock Supervisor Investigation

On-Farm Issues

Water

Describe Issue:

Temperature Extremes

Describe The Issue:

Air Quality

Describe The Issue:

Feed

Describe The Issue:

Lights

Describe The Issue:

Other

Describe The Issue:

Correction

Describe The Correction:

Infectious Disease

Respiratory

Select One Of The Following:

Airsac

Vaccine Reaction

Other

Describe The Issue:

Guts

Select One Of The Following:

Necrotic Enteritis

Cocci

Other

Describe The Issue:

Lameness

Select One Of The Following:

Bacteria (FHN) (Synovitis)

Reovirus

Kinky Back

Kick Stand

Other

Describe The Issue:

Other

Dermatitis

Mixed

Uneven

Spike

Feed Knockdown

Unknown

Describe:

On Farm Necropsy

Submitted to Laboratory?

AI Swabs Submitted

Was a Feed Sample Submitted

Script Request

Script Request Submitted?

Tack A Picture Of Your Script Request Form

Was This house Treated last flock?

Is This The Second Flock In This House Being Treated?

Is This The Third Flock In This House Being Treated?

Is This The Fourth Flock In This House Being Treated?

Is This The Fifth Flock In This House Being Treated?

Is This More Than The Fifth Flock Being Treated In This House?

Flock Supervisor Signature and Date
Please Sign Below:

Veterinary Review Plan

Antibiotic Treatment (Details in Prescription)

Penicillin

Tetracycline

Lincomycin

Tylosin

BMD

SULFA

Other

Describe Treatment:

Non-Antibiotic Treatment (Run According to Label Directions Unless Instructed Otherwise By Vet)

Amprol

Copper Sulfate

Manage

Other

Describe The Treatment

Management

Cull Affected Birds

Describe Alternative Management:

Further Actions:

Reviewing Veterinarian Signature

For VET use ONLY.

Please Sign Below

Prescription

For Vet Use ONLY.

Prescription Number

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.