Dead Bird Reporting


First Name	Last Name	Middle Initial

Street Address


City	Zip


Home Phone	Work Phone	E-mail

Kind of Bird Reporting


	Please describe condition of bird

Location of dead bird, if different than your address:

Street Address Location of Dead Bird


City	Zip


	Did you retrieve the bird?
	Yes No


	If yes, where is bird located now?

Not all birds will be suitable for testing and may not be retrieved by public health staff.

If more information is needed to determine conditions for testing, someone from the Health Department will call you.

Thank you for participating in the bird surveillance project.

Clark County Public Health: Director John Wiesman
Street Address: 1601 East Fourth Plain Boulevard, Vancouver, WA 98661
Mailing Address: P.O. Box 9825, Vancouver, WA 98666-8825
Main phone: (360) 397-8000
TTY: (360) 397-8407
E-mail: Public.Health@clark.wa.gov

Responsible Elected Official: Board of Clark County Commissioners

For questions or comments regarding the Clark County Web site: Webmaster@clark.wa.gov