Avian - Submittal Form - Research Associates Laboratory

AVIAN SUBMISSION FORM
RESEARCH
A S S O C I AT E S
Owner Name:
Animal Name:
Species:
Age:
L A B O R ATO RY
Specimen Requirements:
LIVE ANIMAL TESTING
Date:
Specimen Source (Please Circle)
Blood
Swab
Check Enclosed
P A Y M E N T
A C C O U N T
14556 Midway Road, Dallas, TX 75244
Phone: (972)960-2221 Fax: (972)960-1997 www.vetdna.com
Acct #
Name
Address
City
State/ZIP
Country
Phone#
Email
Fax
Sex:
Amount:_____________
Credit Card
AMEX
Discover
Master Card
Visa
On File
Exp. Date: ______/______
_________________________________________
Name On Card
_________________________________________
Credit Card Number
Blood - 0.1 ml whole blood
ENVIRONMENTAL TESTING
Swab - Dry sterile swab
POST MORTEM
DNA TESTS $18 each
Anatid Herpesvirus (Duck Herpes)
Aspergillus fumigatus
Aspergillus Genus
Avian Adenovirus
Avian DNA Presence Detection
Avian Gastric Yeast (M. ornithogaster)
Avian Malaria (Avian Plasmodium)
Avian Mycoplasma
Avian Polyomavirus (BFD)
Avian Polyomavirus - Crow
Avian Polyomavirus Finch
Avian Polyomavirus - Goose
Avian Poxvirus
Bartonella Genus
Blastocystis
Bordetella avium
Brucella
Campylobacter Genus
Candida albicans
Candida Genus
Chlamydophila Genus
Chlamydophila psittaci
Clostridium Genus
Clostridium difficile
Clostridium perfringens
Clostridium piliformes
Coccidiodes immitis
Coxiella burnetti
Cryptosporidium
Dermanyssus Genus
Dermestid
Duck Circovirus
Duck Enteritis Virus (DEV/AHV-1)
E. coli
Encephalitozoon cuniculi
Encephalitozoon hellem
Encephalitozoon intestinalis
Enterocytozoon bieneusi
Entamoeba histolytica
Erysipelothrix rhusiopathiae
Fowl Adenovirus (FAdV-A to FAdV-E)
Francisella tularensis
Fungal Pathogens (medically relevant)
Giardia Genus
Helicobacter Genus
Hepatazoon Genus
Klebsiella pneumoniae
Leptospira
Listeria monocytogenes
Leucocytozoon
Malassezia Genus
Marek’s Disease Virus
PANEL TESTS
Psittacine Tri-Plex Panel
Avian Polyomavirus, Chlamydophila psittaci
Psittacine Beak and Feather Disease
Pigeon Test Panel
Pigeon Adenovirus, Pigeon Circovirus,
Pigeon Herpes Virus, Salmonella
M.R.S.A.
Mycobacterium avium
Mycobacterium intracellulare complex
Mycobacterium genevense
Mycobacterium TB
Mycobacterium non-TB
Ornithonyssus Genus
Pasteurella multocida
Pigeon Adenovirus
Pigeon Circovirus (PCV)
Pigeon Herpesvirus (CoHV-1)
Psittacid Herpesvirus (genotypes 1-4)
Psittacine Adenovirus
Psittacine Beak and Feather Disease
Ringworm (Dermatophytes)
Salmonella Genus
Salmonella typhimurium
Sarcocystis falcutela
Sarcocystis Genus
Spironucleus meleagridis
Sexing (DNA)
Toxoplasma gondii
Tritrichromonas Genus
Trypanosoma Ssp.
Other__________________
RNA TESTS $25.00 each
$45.00
$60.00
Avian Bornavirus (PDD)
Avian Coronavirus (IBV)
Avian Influenza
Avian Paramyxovirus (APMV 1 - 11)
Avian Reo Virus
Infectious Laryngotracheitis (GaHV1)
Newcastle Disease Virus (NDV)
Pigeon Paramyxovirus
West Nile Virus
For additional species and tests please visit online @ http://www.vetdna.com

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