157x Filetype DOC File size 0.17 MB Source: science.vla.gov.uk
OIE and FAO Reference Laboratory for Avian Influenza and Newcastle Disease APHA (Weybridge), New Haw, Addlestone, Surrey, KT15 3NB, United Kingdom. Telephone: +44 (0)208 225 7671 Facsimile: +44 (0)1932 357856 Website: http://www.gov.uk/apha Email Address: aiwrl@apha.gov.uk SUBMISSION FORM Submitter’s Name: For APHA use only: Submitter’s Address CVO Name, address, phone and fax number: Phone Number: Fax Number: Email Address: Sample ID* Sample Sample Species* Age Country* Clinical History type* collection date* Region/District (include health and (day/month/year) Vaccination status) *mandatory fields FORM VIR 621 v3 – 05/06/2019 Page 1 of 2 Sample ID* Sample Sample Species* Age Country* Clinical History type* collection date* Region/District (include health and (day/month/year) Vaccination status) *mandatory fields It is an OIE requirement for us as an OIE and FAO Reference Laboratory for Avian Influenza and Newcastle Disease to submit sequence data from notifiable AI and ND samples to public databases within three months of sample receipt. We will do this automatically for H5, H7 and AAvV-1 (NDV) samples submitted to us unless you tick here to agree to submit them yourself within three months. When submitting sequences we would like to acknowledge your laboratory. Please provide us with author names of those involved in this submission for acknowledgement. FORM VIR 621 v3 – 05/06/2019 Page 2 of 2
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