Wildlife Seizure Response Checklist Form
Complete this form to document and manage all critical aspects of a wildlife seizure incident.
Date and Time of Incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Seizure
*
Type of Seizure
*
Live Animal(s)
Animal Parts/Products
Eggs
Other
Species Involved
*
Quantity Seized
*
Condition/Status of Seized Wildlife
*
Please Select
Alive
Deceased
Injured
Unknown
Immediate Actions Taken
Secured Wildlife
Provided First Aid
Transported to Facility
Collected Evidence
Other
Reporting Officer/Responder Name
*
First Name
Last Name
Agency Notifications Required
Wildlife Authority
Law Enforcement
Veterinary Services
Other
Follow-up Disposition/Next Steps
Submit Checklist
Should be Empty: