Waterfowl Breeding Survey
Help monitor and protect waterfowl populations by reporting your breeding season observations.
Observer Name
*
First Name
Last Name
Email Address
*
example@example.com
Date of Survey
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Survey Location (Site Name or Description)
*
Habitat Type
*
Lake
Pond
Marsh
River/Stream
Wet Meadow
Other
Weather Conditions During Survey
*
Clear/Sunny
Partly Cloudy
Overcast
Rainy
Windy
Waterfowl Species Observed and Breeding Evidence
*
Rows
Breeding Evidence
Number of Individuals
Mallard
None
Pair Observed
Nest Building
Incubating Adult
Brood/Young Observed
Canada Goose
None
Pair Observed
Nest Building
Incubating Adult
Brood/Young Observed
Wood Duck
None
Pair Observed
Nest Building
Incubating Adult
Brood/Young Observed
Northern Pintail
None
Pair Observed
Nest Building
Incubating Adult
Brood/Young Observed
Blue-winged Teal
None
Pair Observed
Nest Building
Incubating Adult
Brood/Young Observed
Other (specify below)
None
Pair Observed
Nest Building
Incubating Adult
Brood/Young Observed
If 'Other' species observed, please specify:
Habitat Suitability for Breeding (Rate the overall suitability of this site for waterfowl breeding)
*
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
Disturbances Noted (e.g., predators, human activity, pollution)
Additional Comments or Observations
Submit Survey
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