Dead Bird Sighting Report Form, 2010

This form is to be completed by members of the public wishing to report dead crows, ravens, magpies or jays. This information will be used by public health to help assess the risk to human health of West Nile Virus during 2010. Public reports of dead birds are useful and appreciated, however do not mean that a reported bird will be collected or tested. In BC, separate collection and testing programs are in place which operate independently of public reports.

Information on how to safely dispose of dead birds

Please complete a separate form for each location where dead birds were found.

PLEASE NOTE: To correct information submitted in error, please email WNvInquiry@bccdc.ca. This e-mail caters only to correction requests for data entry errors on "Dead Bird Sighting Report Form".

Where were the bird(s) found?

Municipality (city/town) (or nearest municipality, if rural)

Complete either section A or B, as appropriate

A) Bird found in urban centre

Address #

Direction

Street Name

Street Type

Postal Code

e.g. 655

e.g. W

e.g. 12th

e.g. Ave

e.g. V5Z 4R4

Street intersection

e.g. Ash Street

e.g. W 12th Ave

B) Bird found in rural area

Directions/Distance from nearest town

e.g. 40km W of Kamloops on Hwy 1/97

If known, GPS coordinates (Lat/Long in Deg, Min, Sec - NAD83)

N	Deg	^o	Min	'	Sec	"

W	Deg	^o	Min	'	Sec	"

Number of dead birds found at this location?

Photographs and descriptions of dead birds.

Crow

Raven

Magpie

Steller's Jay

Blue Jay

Clark's Nutcracker

Who is submitting this report?

		First Name		Last Name
		Email		Phone #