LABORATORY SUBMISSION FORM

3. Please fill out the lab submission form as completely as possible.  If a large number of samples are submitted (for example culling) then use the "Gross Description" or "Brief History" area listing all the animal ID’s.  Also note if the "Carcass is retained at farm" and if not then note, "Where the carcass is located" (name of buyers freezer, burial site, renderers name, etc.).  Accredited and regulatory veterinarians collecting samples be sure to sign and note your MI license number on submission form for future accreditation purposes.
   
4. Use the submission forms supplied by the MDA. These supplied forms have the account number for the CWD Surveillance Program preprinted on them for billing purposes (31838). For additional forms please call the MDA CWD office at (517) 241-1557 or call the main desk at (517) 373-1077 and request the forms.
   
5. You MUST fill out the owner and premise (farm) name and address in the upper right corner of the submission form. Be sure MDA-CWD is in the upper left corner as submitter for billing and program tracking purposes. "Specimen(s) Submitted" would be brain and lymph nodes. Note "How Many?" of each tissue type being submitted. Test requested is CWD Immunohistochemistry (IHC). Species is Cervidae and Breed is whatever it is that is being tested (elk, red deer, WTD, Sitka deer, etc.). Note total number of cervidae on farm and the number sick (euthanized) and found dead in the total number in current submission. Fill out date animal died (euthanized) and date samples collected.
   
6. DO place a copy of the completed submission form in a water proof (plastic food-Type, zip lock, etc.) bag and place it under the shipping box cardboard lid while on top of the inner sample container.
   
7. DO KEEP A COPY OF THE COMPLETED SUBMISSION FORMS IF YOU WILL BE SUBMITTING THE SAMPLES BY ANY OTHER MEANS THEN THROUGH THE MDA COURIER SERVICE.

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