PLEASE READ BEFORE YOU BEGIN:

2. First Name of Reporting Party
3. Last Name of Reporting Party
5. Reporting Party's Email Address
6. Reporting Party's Phone Number
8. Date & Time of Coyote Sighting or Activity
   Date & Time of Coyote Sighting or Activity

   Date & Time of Coyote Sighting or Activity
9. 
11. Street Name/ Address of Occurrence
13. Closest Intersection
15. Number of Adult Coyotes Observed
    -- Select One --OneTwoThreeFourMore than four
16. Number of Young Coyotes Observed
    -- Select One --OneTwoThreeFourMore than Four
18. Was the coyote being intentionally fed?

    1. Yes
    2. No
19. Was there pet food present?

    1. Yes
    2. No
21. Were other food attractants present?

    1. Yes
    2. No
22. Was a pet involved?

    1. Yes
    2. No
23. Type of Pet

    1. Cat
    2. Dog
    3. Other
24. Was pet on leash?

    1. Yes
    2. No
26. Description of Interaction/ What Happened
28. Any Actions Taken by Reporting Party
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field