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Report Sick or Dead Poultry Birds
(chickens, turkeys, quail, pheasants, peafowl, domesticated ducks and geese)
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Contact Information
First Name
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Last Name
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Address
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City
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State
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Zip Code
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Phone
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Email
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Location of Poultry
Location Address
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City
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County
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State
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Zip Code
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Details of Event
Date illness was first observed
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MM
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DD
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YYYY
Species (check all that apply)
Chicken
Turkey
Quail
Domesticated Ducks
Domesticated Geese
Other:
Approximate number of sick birds
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Clinical signs observed (check all that apply)
Respiratory signs (sneezing, coughing, nasal discharge, swollen infraorbital sinuses)
Ruffled feathers
Decreased egg production or eggs with soft shells/shell-less
Swollen and/or congested wattles and combs
Edema and/or red discoloration of shanks and feet
Diarrhea
Central Nervous System (CNS) impairment
Death loss
Other relevant information
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Number of dead birds
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