Disease Research Laboratory 4th Floor (414) Microbiology Department University of Otago 720 Cumberland Street Dunedin __________________________________________________________________________ ParalisaTM Laboratory Request Form Laboratory Requirements All samples are to be booked in by phone or email prior to sending. Booked in samples will be given priority. Phone: 03 479 7710 Email: drl@otago.ac.nz 1x red top tube clearly identifying animal is required for the ParalisaTM test. Reporting Results Expected turnaround time for results is 5 – 7 working days. If results are urgent then please let the laboratory know at the time of booking. DRL undertakes to perform all tests to the standard approved by the CVO but it makes no claim to the tests being 100% accurate. Paralisa™ Results Results will be reported as Negative (Neg), Suspect (Sus) or Positive (Pos). Results will be provided to the vet involved, if indicated by the farmer. No other agency will receive this data. Farmer Details Farmer Name: Phone: Farm Name: Email: Postal Address: AHB Herd No: DDCM Name: Vet Details Vet Name: Phone: Vet Clinic: Email: Postal Address: Invoice to be sent to: Farmer □ Submitter □ Authorized Signatory______________________ Terms & Conditions University of Otago retains ownership of all information and intellectual property derived from the analysis of samples submitted. The Accounts Receivable Section in the Financial Services Division manages the collection of debt for the University of Otago. A Statement of all invoices issued in the current month is sent to the debtor at the end of the month. It is University practice that all invoices on these statements are to be paid by the 20 th of the month following (normal commercial practice) If the debt remains unpaid after 90 days, the debt will be referred to a collection agency, collection costs will be incurred by the debtor ParalisaTM Laboratory Request Form Farm Tag Sex Age Farm Tag Sex Age