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You are here: Agriculture » Farming and Management » Chemical Use » Veterinary Chemicals » Recording Veterinary Chemical Use » Veterinary Advice Note

Veterinary advice note

Veterinary practice
Address
	Phone no.

Livestock owner:

Address:

Name of chemical product (Name and concentration of active constituent/s if unregistered):

Particulars of animal/s treated to be treated:

Location (If different from the above address):

Description/s (Species, breed, age, and sex):

Other identification/s (e.g. ear tag numbers or names, if more than one animal):

Number of animals:

Dose rate (Amount of chemical product to be administered to each animal):

Method of administration (e.g. drench, intramuscular injection, topical):

No. of treatments:

Date of first treatment:

Re-treatment interval:

The withholding period is: ______ days after the last treatment* OR Nil withholding period required*

*Prescribed/*dispensed by (*Delete one ):
Signature of owner/agent of owner:	Date