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SICK OR DEAD BIRD AND MAMMAL OBSERVATION REPORT

Instructions: This form can be used for all disease surveillance purposes.  Please complete and submit one report for each species of animal seen at each observation.  Due to funding reductions, birds will be accepted by the DNR for gross (visual) examination, but further testing, including West Nile Virus (WNV) testing, will not be routinely performed. Please see the WNV instructions page for more information. Testing for Avian Influenza will only be performed when there is a die-off of 6 or more water birds of the same species at one location or under special circumstances.

Note:  Contact information will only be used for follow-up observations and will not be released. Although we try to answer questions submitted, we do not contact every person submitting a report. For further information please call the DNR Wildlife Disease Lab at 517-336-5030.

Please fill-out the report as completely as possible. All data requested are important.

DATE OF OBSERVATION:    
LOCATION OF OBSERVATION: (see notes)
Zip Code: Nearest City, Town or Village:
County: Street Address: 
Nearest Crossroads:
ANIMAL(S) OBSERVED:
Class:
Bird
Mammal
Species: (select only one)
 

 
If "Unknown," please describe the animal or
if "Other," please enter the species:
Number Observed: Current Status:
Symptoms/clinical signs of affected animal:
COMMENTS:
OBSERVER INFORMATION: (see notes)
Name:


Licensed Rehabilitator or Veterinarian?
No Yes

Phone: - -
E-mail:


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