QMS Pigs Assurance Scheme Compliance Version July Name and postcode of unit.. Name of unit(s)... QMS membership number(s).. Slap mark(s)..

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Quarterly Vet Report SECTION A: GENERAL DETAILS Date of visit. Unit Type (tick as appropriate) Indoor/Outdoor Breeder/Weaner/Grower/Finisher/Other.... Name and postcode of unit.. QMS membership number.. Slap mark(s)... If live pigs are sourced from other units please provide details below: Name of unit(s)... QMS membership number(s).. Slap mark(s).. SECTION B: GENERAL INFORMATION Hospital pens Medicines: records, storage Health plan Euthanasia policy Dead pig storage and disposal Compliant Non-compliant (give details below) Other (give details below) Notes on non-compliance or welfare s since the last veterinary visit: Has a Real Welfare assessment been completed?... How many pigs were assessed?. Has an antibiotic usage audit been completed?... Is a No Medication Policy in operation?... Date Veterinary Health and Welfare Plan was last reviewed and updated... Name of the attending vet (Please Print) Veterinary practice... PVS Membership Number... Telephone... Postcode. Signature of Vet... Date... Page 1 of 5

SECTION C: BREEDING HERD (Gilts, sows and boars) If no breeding herd is present on the unit, please move to section E. Number of sows from farm records.. or estimated number of sows.. Number of gilts in breeding herd from farm records.. or estimated number of gilts.. Abortions Regular returns Irregular returns NIPs Delay in puberty Sow condition Sow mortality No s Mild/moderate level of High level of Other (give details below) Optional notes on the breeding herd since the last quarterly veterinary visit: Page 2 of 5

SECTION D: FARROWING HOUSE (Farrowing sows and litters) If no breeding herd is present on the unit, please move to section E. Mastitis Agalactia Perinatal scour Mid lactation scour Pre-weaning scour Meningitis Arthritis in piglets Stillbirth Neonatal mortality Piglet viability Variable piglet size within litter Born alive No s Mild/moderate level of High level of Other (give details below) Optional notes on farrowing since the last quarterly veterinary visit: Page 3 of 5

SECTION E: WEANERS, GROWERS AND FINISHERS If no weaners, growers or finishers are present on the unit, please move to section F. Has the unit been empty for the full quarter? Number of weaners up to 30kg from farm records.. or estimated number of weaners.. Number of growers 30-60kg from farm records.. or estimated number of growers.. Number of finishers 60kg to sale from farm records.. or estimated number of finishers.. Please use the key below to complete: Key: Respiratory Scour without blood Scour with blood Meningitis Sudden death Vice Poor growth rate Acquired defects Weaners Growers Finishers 1 = No Concerns 2 = Mild/moderate level of 3 = High level of 4 = Other (give details below) Optional notes on weaners, growers and finishers since the last veterinary visit: Page 4 of 5

SECTION F: DIAGNOSIS OF MAJOR INFECTIONS This is the opinion of the attending vet, based on information available at the time of completing the form and is no way legally binding. Presence of the following diseases based on known or reported history, clinical or laboratory results. Don t Likely Confirmed Likely Confirmed know negative negative positive positive PRRS Mycoplasma hyopneumoniae Actinobacillus pleuropneumoniae Mange B. hyodysenteriae (Swine Dysentery) Streptococcus suis Notes on disease status since the last veterinary visit: Are there unusual clinical signs suggestive of new or emerging disease? Has there been an increase in antibiotic use over the last quarter or since the last veterinary visit and if so please state the reason for this? Have there been any significant changes to buildings, management procedures or practices over the last quarter or since the last veterinary visit and if so, please provide details? Are internal and external biosecurity measures in place and if so please indicate areas for improvement? Page 5 of 5