Microchip Adverse Event Reporting

Chip Details

Chip Number

Chip Manufacturer (optional)

Implantation Date (optional)

Please enter the Day, Month and Year. For example, 12 11 2007

Day

Month

Year

Implantation Site

Between shoulder blades (dogs,cats,ferrets,rabbits)

Nuchal ligament (horses and donkeys)

Left hind leg (tortoises, turtles, terrapins and lizards)

Left neck (snakes)

Left pectoral muscle (birds)

Other

Other (optional)

Name of Implanter (optional)

Address postcode (optional)

Implanter Occupation

Event Details

Event First Detected

Please enter the Day, Month and Year. For example, 12 11 2007

Day

Month

Year

Event Type

Reaction

Describe the reaction observed including details of any other injections or injury to this region in the previous 2 weeks

Failure

Has a full body scan been performed?

Has the scanner been confirmed to be working?

Has the chip location been confimed by x-rays or ultrasound?

Can the chip be felt under the skin?

Migration

New location of chip

Has the chip location been confirmed by x-rays or ultrasound?

Can the chip be felt under the skin?

Reporter Details

The VMD will process your personal data in accordance with the VMD’s personal information charter at https://www.gov.uk/government/organisations/veterinary-medicines-directorate/about/personal-information-charter, which includes a link to the VMD’s privacy notice. We ask for contact details so we can get in touch if we need more information.

I don't want you to contact me

Name

Address postcode (optional)

Telephone Number (optional)

Reporter Occupation

E-mail

Reference (optional)

Vet Details

The Vet and Reporter are not the same person.

Name (optional)

Address postcode (optional)

Telephone Number (optional)

E-mail (optional)

Microchip Adverse Event Reporting Form

Chip Details

Animal Details

Event Details

Reporter Details

Vet Details