Worm Count Sample Form - Shopify

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EasyWormer will supply FEC results to your Vet for use in an investigation of suspected parasite related disease. EasyWo

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Worm Count Sample Form - Shopify

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for use in an investigation of suspected parasite related disease. EasyWormer does not provide a diagnostic service or s

Worm Count Sample Form Fecal Egg Count – Fecal Egg Retest Procedure to send and samples to our laboratory for testing. 1. Collect sample

A ball of poo less than 12 hours old

2. Documentation & send

Address as follows:

EasyWormer PO Box 301 Orange NSW 2800 * Exempt animal specimens

Sample Name/ID

Date collected

Age

Sex

(M/S/G)

If foal: Foaling date

If pregnant mare: due date

If fecal egg re-test:

most recent worming: Wormer name

Date given

1. 2. 3. 4. 5. 6. 7. 8.

DECLARATION



By ticking this box, I have read and agree to the EasyWormer Fecal Egg Count Laboratory Services Terms and Conditions that can be accessed at easywormer.com.au/pages/easywormer-terms-andconditions or provide to you by contacting our [email protected] By signing below, I declare I am authorised to request analysis of the samples listed above. Name: Signature:

© EasyWormer 2017 – All rights reserved.

Date:

TESTING REQUIRED

   

Fecal egg count FEC - Individual egg count Fecal egg re-test FECRT after worming - Individual egg count Pinworm test Larval differentiation +$20 per sample (only available in conjunction with above – we will contact you if you would like this service (you need to have a positive FEC above before we can do this test)

CUSTOMER DETAILS Company Name & ABN: (if applicable) Contact

Phone:

Email for results

Nominated Veterinarian:

Property address:

PIC:

Postal address:

RECEIPT - PRE PAYMENT REQUIRED To test your samples we require that you have pre-paid for the testing online at easywormer.com.au/ Invoice/Order Number

Date:

PLEASE PACK THIS PAPERWORK IN A SEPARATE ZIPLOCK BAG AND INCLUDE WITH YOUR FECAL SAMPLES IN A PADDED BAG AND ADDRESS TO: EASYWORMER PO BOX 301 ORANGE NSW 2800 *Exempt animal specimens

LIMITATIONS OF A FECAL EGG COUNT The limitations of a FEC means that the test results do not provide a "diagnosis" or exclusion of worm related disease when used in isolation. Your veterinarian is the only person who can examine your horse and consider FEC test results in combination with clinical findings, treatment history and the results of any other testing that they have done to support a diagnosis of worm related disease. EasyWormer will supply FEC results to your Vet for use in an investigation of suspected parasite related disease. EasyWormer does not provide a diagnostic service or specific advice relating to the diagnosis, treatment and/or prevention of worm related disease in an individual horse. Only your vet can provide this service. Veterinary advice should be sought both in relation to parasite control programs and prior to undertaking any parasite treatment program.

© EasyWormer 2017 – All rights reserved.