VACCINATION QUESTIONNAIRE Please mail to : S.T.A.R.* Ferrets, c/o Pam Grant, PO Box 1714, Springfield, VA 22151-0714 Due to the recent controversy concerning canine distemper vaccines, their uses and their results, S.T.A.R.* Ferrets has decided to rerelease the following survey. We are interested in finding out which vaccines are being used for ferrets, how they are being administered, by whom, and the results. If you vaccinate your own animals and wish to remain anonymous, please just fill in the city and state where you live. If you or your veterinarian have any more information to provide, please feel free to write details. 1. What vaccine are you using to protect ferrets against canine distemper? FERVAC - D GALAXY -D OTHER: ___________________________ 2. Who is administering the shot? SELF VET OTHER: _______________ 3. Where is the ferret being injected? NECK AREA SHOULDER AREA HIP AREA RUMP AREA ARM AREA LEG AREA OTHER: ___________________________ 4. Is the vaccine warmed to room temperature before being injected? YES NO 5. What gage needle is being used? 22 25 OTHER: ________ 6. What length needle is being used? 3/4" 1" OTHER: ________ 7. Are you using the sterile solution which is packaged with the vaccine? YES NO 8. Have you ever used any other canine distemper vaccine? YES NO If so, which one(s): FERVAC-D GALAXY-D OTHER: ________________ 9. Are you having any reactions with your present canine distemper vaccine? YES NO 10. Have you had any reactions with your past canine distemper vaccine? YES NO 11. Please list any reactions & % below: PRESENT VACCINE _PAST VACCINE__ a. no reactions __________________ _________________ b. stings ferret while injecting vaccine __________________ _________________ c. ferret screams while injecting vaccine __________________ _________________ d. ferret becomes lethargic after vaccination __________________ _________________ e. vomiting occurs after vaccination __________________ _________________ f. seizures occur after vaccination __________________ _________________ g. other problems: __________________ _________________ h. lot number & date on the vaccines: __________________ _________________ i. was this shot given in conjuction w/rabies: __________________ _________________ j. month/year of vaccination(s): __________________ _________________ k. how many vaccines have you used/year: __________________ _________________ Name: ___________________________________ City: __________________ State: _______ Signature: ______________________________________ Date: _________________________ [Posted in FML issue 1249]