Form 89-878 Marine Mammal Rehabilitation Disposition Report

MARINE MAMMAL REHABILITATION DISPOSITION REPORT
FIELD #: __________________________ NMFS REGIONAL #______________NATIONAL DATABASE#: _________________________________
(NMFS USE)
(NMFS USE)
COMMON NAME: _______________________________ GENUS: _________________________ SPECIES: _______________________________
REHABILITATION FACILTY: ________________________________________ Affiliation: ______________________________________________
Address: ______________________________________________________ Phone:___________________________________________________

STRANDING/BIRTH HISTORY
□ Restrand
Date: Year: _____ Month:______ Day: ______
Location: State: _______ County: __________ City: ___________
Sex:
□ 1. Male
□ 2. Female
Was this animal born to a female in rehab?
□ 1. NO □ 2. YES; Female’s ID #: _______________
MEDICAL RECORD

ADMISSION INTO REHABILITATION
Date: Year: ________ Month:_________ Day: _________
Received From: _________________________________
Straight Length:___________ □ cm □ in □ actual □ estimate
Weight:_________________ □ kg □ lb □ actual □ estimate
SPECIMEN TRACKING
Samples Collected:
□ 1. YES □ 2. NO
□ 1. Scientific collection
□ 2. Education collection
□ 3. Other: _______________________________________

Pre-Release Health Screen Date:
Year:______ Month:______ Day:______
Last Day of Antibiotics: Year:______ Month:______ Day:______
MORPHOLOGICAL DATA AT DISPOSITION
Animal Morphological Data at Time of Disposition:
Straight Length:_____________ □ cm
Weight:___________________

□ kg

Age Class at Time of Disposition:

□ in □ actual □ estimate □ 1. Adult
□ lb □ actual □ estimate □ 2. Subadult

□ 1. Transferred to Another Rehabilitation Facility
Year: ________ Month:_______ Day: ________
Facility:____________________________________________
Address:___________________________________________
Comments:_________________________________________
__________________________________________________

□ 3.Yearling
□ 4. Pup/Calf

□ 5. Unknown

□ 6. Released
Year: ________ Month:_______ Day: ________
State: ______ County:__________ City:___________________________
Locality Details:_______________________________________________
Latitude (DD):________________________________________________ N

□ 2. Temporarily Transferred to Research Facility
Year: ________ Month:_______ Day: ________
Facility:____________________________________________
Comments:_________________________________________
NMFS Permit #: _____________________________________
□ 3. Deemed Nonreleasable and Transferred to Research
Facility
Year: ________ Month:_______ Day: ________
Facility:___________________________________________
Comments:________________________________________
NMFS PPIMS #: _____________________________________
□ 4. Deemed Nonreleaseable and Transferred to
Permanent Captivity
Year: ________ Month:_______ Day: ________
Facility:___________________________________________
Comments:________________________________________
NMFS PIMS #: ____________________________________

□ Euthanized
5. Died
Year: ________ Month:_______ Day: ________
Location:__________________________________________
Cause of Death: ___________________________________
Comments:________________________________________
NECROPSIED □ NO
□ YES □ Limited
□ Carcass Frozen Thawed

□ Complete

Longitude(DD):_______________________________________________W
TAG DATA
Tags Were:
Present at time of stranding (Pre-existing):
Applied during Stranding Response:
Applied During Rehabilitation:
ID#

Color

Type

Placement*
(Circle ONE)
D DF L
_________________________ LF LR RF RR
D DF L
_________________________ LF LR RF RR
D DF L
_________________________ LF LR RF RR

□ YES
□ YES
□ YES

□ NO
□ NO
□ NO

Applied

Present

□

□

□

□

□

□

* D= Dorsal; DF= Dorsal Fin; L= Lateral Body
LF= Left Front; LR= Left Rear; RF= Right Front; RR= Right Rear

Post Release Biomonitoring
□ YES
□ NO
Data Disposition: _______________________________________________

□ Carcass Fresh

NECROPSIED BY: _______________________ Date _____________

NOAA Form 89-878 (rev. 2007); OMB No. ________; Expires _________

PLEASE USE THE BACK SIDE OF THIS FORM FOR ADDITIONAL REMARKS