SUBMISSION FORM blood and semen tests of horses for import purposes

Finnish Food Authority • Veterinary Virology Unit • Mustialankatu 3, FI-00790 Helsinki, Finland • Tel. 029 530 0400 • www.foodauthority.fi • firstname.lastname@foodauthority.fi

Additional information to be provided: Export of horses/”Name of owner”/”Name of horse” LAB 1038

Please use block letters

Received Time DNo

Name of veterinary surgeon/Requested by

Address

Postcode Town/City

Reply/invoice Copy

Name of owner

Address

Postcode Town/City

Telephone/email

Reply/invoice Copy

Type of sample serum blood semen

Date of sampling Species/breed Date of birth

Microchip/Tattoo/Identification number sex

Name of the animal

Requested tests infectious anemia malleus dourine

viral arteritis neutralization test

(serum) virus isolation (semen)

Test price has been paid Attach copy of proof of payment

Date Signature of veterinary surgeon

Telephone/fax/email