Humane Mouse Trap and Release Log Form
Log each humane mouse trap capture and release event. Please complete all fields for accurate record keeping.
Trap/Event Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Trap or Station Location
*
Submitter or Observer Name
*
First Name
Last Name
Trap ID or Station Identifier
*
Capture Status
*
Mouse captured
No capture
Trap not checked
Number of Mice Captured
*
Mouse Condition at Check
Please Select
Active and healthy
Lethargic
Injured
Deceased
Other
Release Location
*
Release Outcome
Please Select
Mouse released successfully
Mouse did not survive
Other
Notes / Observations
Submit Log Entry
Should be Empty: