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3 - Request To Update FAVN Report (2024)

The document is a request form for updating information on the Rabies FAVN Report from the Kansas State University Rabies Laboratory. It includes sections for the animal's details, updated report send-out information, and a signature from the veterinarian. The form also provides instructions for payment and additional information regarding report submissions.

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Nicolle Rendon
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152 views1 page

3 - Request To Update FAVN Report (2024)

The document is a request form for updating information on the Rabies FAVN Report from the Kansas State University Rabies Laboratory. It includes sections for the animal's details, updated report send-out information, and a signature from the veterinarian. The form also provides instructions for payment and additional information regarding report submissions.

Uploaded by

Nicolle Rendon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Kansas State University Rabies Laboratory - Manhattan, KS 66502

Request to Update Information on the


Rabies FAVN Report Form
The Rabies Laboratory Phone: 785-532-4483
Kansas State University Fax : 785-532-4474
Kansas State Veterinary 2005 Research Park Circle Email: [email protected]
DIAGNOSTIC LABORATORY Manhattan, KS 66502 http://www.ksvdl.org/rabies-laboratory/

I hereby request the Kansas State University Rabies Laboratory to update information on the
Rabies Serology Report Form. I have verified the updated information to be accurate and true.
Name of Animal:
Microchip Number:
Accession Number of Report:
Destination: Departure date:

ITEM TO UPDATE CURRENT INFORMATION UPDATED INFORMATION

Updated Report SendOut Information:

Email Address:____________________________________________________________________

If the original FAVN submission form was paper and not completed online, please fill out a corrected
form online at https://www.vet.k-state.edu/favnform.html/.

Name of Veterinary Clinic:

Signature of Veterinarian: Date:

For Lab use only


Date Received: Completed Date:

Test results are sent to the clinic on the FAVN submission regardless of who pays for the test and shipping. However, the FAVN updated report can be sent
to an alternate location i f written and signed permission from the clinic on the request to update information is provided. Payments can be made
online at https://www.vet.k-state.edu/asp/Forms/ksvdl/VDLPayments/ . For payment questions please contact the business office at 785-532-3294 or via
email at [email protected]. All prices are subject to change. *See website for current prices.
KSVDL-RAB-FAVN-F-30-0 Effective Date: 6/20/2022

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