Where is this submission going?

People involved with submission

Person Submitting Case
Name
Agency
Street Address
Township
County
State
Phone
Email
Person Finding Animal
Name
Agency
Street Address
Township
County
State
Phone
Email

Event Details

Date Found
Date Shipped
Location
Street Address or Location
Township
County
State
Latitude
Longitude
Onset Date
End Date
or  
 
Known / estimated total number of animals
Dead Sick Healthy
   
Cause of Death
Are Carcasses

History

 

* Check all that apply






 

Animal Identification

 
  ID #
(if any)
Species Sex Age Captivity State Sample Euthanized Method Euthanized Site Quantity

NWDC Contact

Name of wildlife health specialist who discussed the case with you (if known)

Check information and submit

    
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