Expression of Interest - Victorian producers

This form collects basic information from Victorian farmers who are interested in participating in the FarmVet Connect Program. Veterinary Support Services will contact you directly for further information as appropriate in the near future.

Thank you for expressing interest in this pilot program.

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* 1. Personal Details

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* 2. Contact Details

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* 3. Mobile Phone Number

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* 4. Which production system best describes your main operation?

Beef

Dairy

Mixed Beef/Sheep

Sheep

Mixed Dairy/Beef

Other (please specify)

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* 5. Please provide details of your farm and location.

Farm Business Name

Location

Postcode

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* 6. How many livestock animals are you currently managing on this farm?

0 - 50

51 - 100

101 - 200

201 - 400

401 - 600

601+

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* 7. Do you have a regular vet clinic that services your farm?

Yes

If yes, please provide the veterinary clinic name (and veterinarian if applicable).

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* 8. Select any of the following industry activities you participate in.

Farm discussion groups

Dairy Industry R&D events

Beef Industry R&D events

Sheep Industry R&D events

Member of agriculture industry group e.g. VFF, AWI, MLA, Gippsland Agricultural Group etc

Other (please specify)

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* 9. Which statements best reflect why are you interested in the FarmVet Connect program? (multiple answers allowed)

I want to strengthen relationships with my local vet clinic

I want to develop a greater understanding of vet services for farming

I want to contribute to the next generation of animal health professionals

I think giving back to my rural community is important

I want to be able to communicate better with vets

I want to build networks in my region

I am interested in knowing more about the program

Other (Please provide details)