1.800.858.7378 npic@ace.orst.edu
We're open from 8:00AM to 12:00PM Pacific Time, Mon-Fri
1.800.858.7378 npic@ace.orst.edu
We're open from 8:00AM to 12:00PM Pacific Time, Mon-Fri
The Veterinary Pesticide Incident Reporting portal is only for use by veterinarians or their staff to report adverse effects of an animal's exposure to pesticides.
The purpose of this system is to gather information from qualified medical professionals. Use of this system by others is strongly discouraged and may result in the termination of this service.
Information from this portal may be directly sent in its entirety to the U.S. Environmental Protection Agency. Data from this portal may be used to inform decision-making in the federal regulation of pesticides. Please note that the information submitted through this portal will not be used for targeted enforcement. If you wish to speak with someone about a potential investigation, please contact your state's pesticide regulatory agency for enforcement.
If you have questions or would prefer to report any adverse effect of a pesticide through the NPIC hotline, you may do so by calling NPIC at 800-858-7378.
The following details about the pages and fields in the portal may be helpful when entering an incident report into the portal.
| Field | Required? | Description/Options |
|---|---|---|
| Name | Yes | Provide your name |
| Title | Yes | Choose your occupation: Veterinarian Technician Other (please specify) |
| Clinic/Company Name | Yes | Enter your organizations name |
| Street Address | Yes | Enter your address |
| City | Yes | Enter your city |
| State | Yes | Click to select a state |
| Zip Code | Yes | Enter your zip code |
| Phone Number | Yes | Enter your phone number |
| Email Address | Yes | Enter your email address |
| Field | Required? | Description/Options |
|---|---|---|
| Pesticide Registration Number | No | Please provide the EPA Registration Number if possible. The Registration Number is located on the pesticide product labeling. This number is extremely important for reviewers to accurately record and assess an incident. The pesticide registration number, a.k.a. "EPA Reg. Number," is the best piece of information about a product you can give us. The EPA Reg. Number provides a unique identifier for a specific product. You should be able to find the EPA Reg. Number on the product label, usually in fine print close to where the active ingredients are listed. The number will usually have at least one hyphen in it -- be sure
to enter the number exactly as shown, including any hyphens,
e.g. |
| Product Name | No* | If you do not know the EPA Registration Number, please provide the pesticide product name and the active ingredient if you can. Many products have similar names. Providing the name and the active ingredient will allow reviewers of the report to better assess the incident. Many products have similar names and without the Registration Number reviewers will not be able to accurately record the product without both the name and active ingredient(s) as well. *You will not be able to proceed to the next page without entering either an EPA Reg. No. or both a Product Name and Active Ingredient. If complete product information is not available, enter "Unknown." |
| Active Ingredient: | No* | To ease entering complex ingredient names, you can type the first few characters and a list of matching ingredients will be provided that you may choose from. *You will not be able to proceed to the next page without entering either an EPA Reg. No. or both a Product Name and Active Ingredient. If complete product information is not available, enter "Unknown." |
| AI% | No | Enter the percentage concentration of the active ingredient, if known. |
| Type of Pesticide | No | Choose the type of pesticide from the list provided:
|
| Formulation | No | Choose the product's formulation from the list provided:
|
| Field | Required? | Description/Options |
|---|---|---|
| Species | Yes | Choose the species from the list provided:
|
| Breed | No | Provide the common breed of the species |
| Sex | No | Choose the sex of the species from the list provided
|
| Age | No | Enter the age and choose either days, months, or years |
| Weight | No | Enter the weight in pounds (lbs) or kilograms (kg) |
| Date of exposure | No | Enter the date of exposure in month/day/year format. |
| Date of examination | No | Enter the date of examination in month/day/year format. |
| In what U.S. state/territory did the exposure occur? | Yes | Click to select a state |
| Route(s) of Exposure (to pick more than one -- hold the [ctrl] or [command] key while clicking) | Yes | Choose an exposure route from the list provided:
|
| Additional Details of Exposure | No | Summarize additional details of the exposure here. |
| Toxicity/signs (to pick more than one -- hold the [ctrl] or [command] key while clicking) | Yes | Choose the signs/symptoms from the list provided: Neurological:
Other (describe below) |
| Additional Details of Toxicity | No | Enter a summary of relevant clinical signs and/or a brief summary of lab work |
| Onset of symptoms | No | Enter the time in minutes, hours, or days |
| Outcome | Yes | Choose an outcome from the list provided:
|
| Additional Details of Outcome | No | Enter a summary of additional details of outcome |
Optional: Please enter any additional information about the exposure as needed.
You may also use this screen to provide feedback or general comments to us about this reporting system, or you can Skip This Screen if you'd prefer.
The "Skip This Screen" button is available to skip past the form entirely.
Information from this portal may be directly sent in its entirety to the U.S. Environmental Protection Agency. Data from this portal may be used to inform decision-making in the federal regulation of pesticides. Note that NPIC cannot ensure that personally identifiable information included in these reports will be kept confidential. Also note that the information submitted through this portal will not be used for targeted enforcement. If you wish to speak with someone about a potential investigation, please contact your state's pesticide regulatory agency for pesticide enforcement, or contact the U.S. Environmental Protection Agency at Report.Pesticide.Incident@epa.gov.
This page provides a complete summary of the information entered into the report so far. The report has not been saved yet. You can save the report without review by clicking the "Save Immediately" button at the top of the page. You can also review the report and make changes using the various "Change..." buttons as necessary, and then save the report using the "Save" button at the bottom of the page.
Once you see this page, the report has been saved into the database and cannot be edited further. You may wish to record the Report ID if you wish to contact us about the report.
Thank you for using the Veterinary Pesticide Incident Reporting Portal!
