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Sample MAP inspection form provided by CBS for informational purposes


Model Avicultural Program
Inspection Form NO. 000
Applicant's Name ________________________ Telephone Number ________________________
Street Address ____________________________ City, State, Zip Code _______________________
Veterinarian ______________________________ Telephone Number __________________
Street Address ___________________________ City, State, Zip Code _______________________
FOR OFFICIAL USE ONLY:     [_] Approved    [_] Not Approved

A. FACILITIES:
Quarantine		 Circle Yes/No/Number
1. Is there a quarantine area/room/facility provided for new entries to the collection? YES NO
2. Is the quarantine area adequate for the control of infectious disease when using standard quarantine techniques? YES NO
Technique Used:
Time ________________________________________________
Laboratory Testing _____________________________________
Other ________________________________________________
3. Is there a policy of health status determination? 1 2 3 4 5
Please Describe: _______________________________________
_____________________________________________________
_____________________________________________________
4. Is there an identification sistem in operation in the collection? 1 2 3 4 5
5. Is there a sex determination technique in use for establishing potential breeding pairs? YES NO
6. Is there a quarantine record system in use? YES NO
7. Are disinfectants used in the quarantine area? YES NO
B. FLIGHTS
8. Is there a safety door/aisle system in operation? YES NO
9. Do the safety doors and pen doors have locks? YES NO
10. Is the size, shape, and design of the flight appropriate for the species being housed? 1 2 3 4 5
11. Is there a rodent control system in operation? 1 2 3 4 5
12. Can the flights be easily cleaned and sanitized? YES NO
13. If it is necessary to capture a bird, can this be acconplished quickly and effectively? YES NO
14. Can next boxes or the nesting are be disinfected or routinely replaced? YES NO
15. Is there easy access to nesting box/area for inspection? YES NO
C. NUTRITION
16. Is the nutritional plan appropriate for the species being kept? YES NO
17. Is the method of food storage adequate? YES NO
D. PEDIATRICS
18. Are the sanitation procedures in the nursery adequate for the production of healthy offspring? YES NO
19. Are individual young or clutches housed and fed in a manner so as to minimize transmission of infectious disease agents? YES NO
20. Are the young developing within normal physical parameters for their species? YES NO
21. Is there a means of weighing the young in the nursery? YES NO
22. Are the hand feeding young fed fresh formula daily? YES NO
23. Is there an individual record kept on all young that are handfeeding? 1 2 3 4 5
24. Is there a system for disinfecting the hand feeding equipment? YES NO
25. Are there appropriate temperature and humidity controls for the brooders/nursery? YES NO
E. RECORD KEEPING SYSTEM
26. Is there a functional record keeping system? 1 2 3 4 5
27. Is there a bill of sale provided when bird ownership is transfered? 1 2 3 4 5
28. Are written instructions regarding nutrition, basic husbandry and general care provided to customers? YES NO

___________________________________ ___________________________________
Applicant's Signature Date Veterinarian's Signature Date


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