This is an updated microchip subscription form for Central Animal Records (CAR).  CAR have inspected and approved the format.

This is a Patient Form that will merge Customer name, address, phone number(s), email address.  You will need to hand-write the municipality.  The form will also merge Patient name, microchip number, species, sex and status, breed, date of birth and colour into a form that resembles the layout of the CAR form.  Practice name and address and clinician details are also added (you will need to hand-write your Vic implanter authorisation number).

Form is set for an A4 page and is compatible with OV v1.5 or higher.

As a result of the discussion at the AVA Vic Div's information night (Fri 23/09/2011) on the new Victorian "Domestic Animals Amendment (Restricted Breeds) Act", I've made a few changes to the form and uploaded it as version 2.

Version 2 uploaded 24 Sep 2011 contains the following changes:
1: I've moved the implanter information to the bottom of the file, below the owner's signature, so that it's more clearly separate from the owner and pet information;
2. I've added "(owner-supplied information)" to the animal details to remove any doubt as to who supplied the information; and
3. I've added a sentence (as suggested by the Guild Insurance lawyer present on the night) under Breed stating "This is in no way an official certification of the breed for the purposes of the Domestic Animals Amendment (Restricted Breeds) Act 2011"

Non-Victorian OV users will need to edit item #3 above in the ODT to include the name of their relevant Act or delete the line completely.

Version 2.15a (uploaded 22 Aug 2012) adds a missing field ("ID Number Of Other Permanent ID Device Implanted (if applicable)") to the form as required by the Victorian Domestic Animals Regulations 2005.  In other respects, it's the same as previous versions, so please update your OpenVPMS installation (v1.5 or higher) with this updated template.