Glossary & References / Wildpro Standard Forms / Electronic version:

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Wildpro
Casualty Record Form

ADMISSION INFORMATION

HOSPITAL Name .
Hospital Case Number  
Name of Staff Member Admitting Animal .
Date & Time Date  
Time  
Species Common name  
Scientific name  
Finder Contact Details Name  
Address .

.

Telephone number (s) .

.

Email .
Signature received for transfer of responsibility?
...

Yes

...

No

 
Sex
...

Male

...

Female

...

Unknown

 
Age Mammal
...

Infant

...

Juvenile

...

Adult

 
Bird
...

Nestling / Downy

...

Fledgling

...

Subadult

...

Adult

Reptile
...

Hatchling

...

Juvenile

...

Adult

 
Amphibian
...

Hatchling

...

Juvenile

...

Adult

 
Body Weight (units = grams) .
Individual Identification Marks (Please specify type of mark and site) Identichip .
BTO ring .
Darvic ring .
Other (Tattoo / Scar) .
History Reason for presentation .

.

Duration in captivity prior to presentation .
Details of any treatment given prior to presentation .

.

.

Details of any food or water given prior to presentation .
Location where animal was found Address .

.

Postcode  
Grid reference  
Geographical points of details .
Contact details of person finding the animal if different from above Name .
Contact Details .

DEATH / RELEASE INFORMATION

Release Time of release Time of day .
Date .
Weather conditions .
Details of method of release (Hard / Soft and general description) .

.

.

Overall Health Status (e.g. healing wounds etc.) .
Number of animals released (Sex and age ratio if applicable) .
Site of release (Grid reference) .
Body weight on release (units = grams) .
Body condition on release
...

Emaciated

...

Thin

...

Normal

...

Fat

...

Obese

Individual Identification Marks (Please specify type of mark and site and re-enter any marks etc. still present that were recorded on admission) Identichip .
BTO ring .
Darvic ring .
Other (Tattoo / Scar) .
Transfer to permanent captivity Name and address of establishment .

.

Description of type of establishment (e.g. zoo, private garden, island on municipal lake etc.) .
Details of person accepting responsibility for care. Name .
Address .

.

Telephone .
Mobile .
Email .
Veterinary Officer (details of veterinary surgeon responsible for the ongoing health care of the animal) Name .
Address .

.

Telephone ..
Signature obtained (of the person accepting responsibility for care)?
...

Yes

...

No

Euthanasia / Died If found dead (including if recorded after release): Was the animal seen alive at any stage post-release? .
If yes, give description of post-release sightings. .
Circumstances of death .
Place of death .
Estimated time between death and discovery of animal .
If euthanased: Reason for euthanasia .
Type of euthanasia .
Post mortem performed?
...

Yes

...

No

Overall findings of Post mortem examination (if performed) .

.

.

Body weight at Post mortem (units = grams) .
Veterinary Officer responsible for overall care .
Staff Member responsible for release / transfer .

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