Form to submit a dead animal Form to submit a dead animal. Notification form for submitting a dead animal for post-mortem investigation Use this form to report a dead animal to be retrieved for post-mortem investigation when deemed appropiate. The animal should be in your possession, be double-bagged and meet certain conditions as mentioned on the previous page. Information concerning the dead animal Animal species: * Date found: * Number of deaths Number sick History of the animal * Dying Less then 6 hours Less then 12 hours Less then 24 hours Less then 48 hours Less then 1 week More then 1 week Unknown how long ago the animal died Information concerning the dead animal * Dying, still alive Found alive, died Found alive, put out of its misery traffic related death or drowning Collisions (Window/ Building/Wind turbines/ Power lines) Caught by cat or dog Gunshot Disease Found dead, other Unknown Remarks, symptoms, signs etc. Information about where the dead animal was found. There are several ways to set the location: Move the pinpoint on the map to the right location Address search: Fill in the address Fill in the GPS-coordinates (decimal degrees) Google Map Place where the animal was found Coordinate: Latitude – longitude Village Municipality Province Uploaden pictures you can upload three pictures (jpg or png). The pictures are reduced in size Select a picture by clicking on a picture or by dragging Picture 1 Select and upload your picture or Drag and drop to upload. Select and upload your picture or Drag and drop to upload. Maximum file size: 102.4MB The pictures are automatically reduced in size Picture 2 Select and upload your picture or Drag and drop to upload. Select and upload your picture or Drag and drop to upload. Maximum file size: 102.4MB The pictures are automatically reduced in size Picture 3 Select and upload your picture or Drag and drop to upload. Select and upload your picture or Drag and drop to upload. Maximum file size: 102.4MB The pictures are automatically reduced in size Contact data Name * Address * Postal code * City * Email * Phone number * Nature organization (if applicable) Collection address dead animal The animal is hygienically double-packaged and stored as cold as possible (preferably between 0 – 7 C) but not in the freezer Address where the hygienically double-packaged animal can be retrieved during working hours: * Animal collection address is address of notifier above Dier ligt op een andere locatie, vul in Contact person and collection address for courier Contact person Phone number contact person Address Postal code City Sign as correct * Ik ga ermee akkoord dat bovenstaande persoonsgegevens worden bewaard voor contactdoeleinden naar aanleiding van deze melding reCAPTCHA When pictures have to be uploaded, it can take some time before the report is sent. Please do not close the page until you see that the report has been received. Indienen If you are human, leave this field blank.
