===== PAGE 1 ===== ## MVDL SUPPLY ORDER FORM ## Clear Form Please see our website to access the MVDL Submission Guide & Fee Schedule for additional information Please contact MVDL to inquire about USDA-regulated program (e.g., livestock market & slaughter) supply orders Due to biosecurity best practices, MVDL will not return Styrofoam or cardboard shippers listed below to submitters for reuse

ITEM	COST	QUANTITY
The following specimen collection and mailing supplies are available; material cost + $2.00 handling + current shipping fees are applied when processed
Abortion Kit	$5.00
Neonatal Diarrhea (Scours) Kit	$5.00
Necropsy Kit	$5.00
Biopsy Kit	$5.00
Blood Tube Shipper – small Styrofoam – holds (5) 10cc tubes	$2.50
Blood Tube/Slide Shipper – medium Styrofoam – holds (4) 10cc tubes + (4) slides	$5.00
Blood Tube/Slide Shipper – large Styrofoam – holds (8) 10cc tubes + (4) slides	$7.50
Blood Tube Shipper – cardboard – holds (100) 10cc tubes	$3.00
Campylobacter tubes (10)	$20.00
Tritrichomonas foetus physiological saline tube	No cost

SUBMISSION FORMS

The following may be downloaded from our website.

Single Animal Submission Form

Multiple Animal Submission Form

Salmonella Testing Submission Form

The following may be ordered from the Montana Department of Livestock Animal Health Office: 406-444-2976

EIA, e.g., VS10-11

SHIPTO:	Veterinarian's Name:
	Clinic Name:
	Billing Account Number (required):
	Shipping Address:
	Phone:

## PLEASE PRINT AND EMAIL, MAIL, OR DELIVER TO MVDL ## LABORATORY USE:

DATE RECEIVED/INITIALS:

DATE SHIPPED/INITIALS:

TOTAL MATERIALS & SHIPPING FEE/INITIALS: