DeadBirdFindingReportForm

Name:

Telephone#:

**Email Address:

"Email address is requested so that we may contact you with our findings..."

The Location where the Bird was found:

**Address:

**City:

**Type of Bird (Select
Bird(s)):

**Total # of Birds Found:

**Date Dead Bird was Discovered:

**The Exact Location of the Dead Bird(s) & Your Additional
Findings..... **PLEASE DESCRIBE HERE IN THE BOX BELOW**:

Thank You for your Report, The NSMAD

If you would like to leave a message instead with the NSMAD district
office, @ (847) 446 - 9434: Please Press/Enter in TWO(2) anytime
during the welcome message and Report your Dead Bird Finding.

For More Information: "Illinois Department of Public Health: Dead Bird Collection"

North Shore Mosquito Abatement District
Dead Bird Finding Report Form

The NSMAD is interested in your findings. This form will help us in
tracking the distribution of the West Nile Virus for our control
efforts in our district. If you could please fill out the following
information and when finished please click on the "Send Form"
button below. Your information is greatly appreciated.

Dead Bird Finding Report Form:

**Everything in ORANGE is Required on the Form Please...**