Section 1. About the amphibians...

In which years have you seen dead amphibians?

How has the amphibian population changed?

Increased   Decreased   Stayed the same

In the most recent year of mortality...

... in which months were the animals dying?

From: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year Pre-2006 2006 2007 2008 2009 2010 To: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year Pre-2006 2006 2007 2008 2009 2010

...how many dead animals were seen in total?

...how much spawn was seen in the pond? Value? Clumps Sq. feet  
Please enter the number of clumps or square footage seen.

...what happened to this years spawn?

No spawn at all  All spawn failed  Some spawn hatched

...what happened to this years tadpoles?

All tadpoles died suddenly  All tadpoles died after a period  
Some tadpoles grew legs and left the water  Too early to say

Which, if any, of the following symptoms did you notice on sick or dead animals? Please tick all that apply

No apparent symptoms

Section 2: About your pond...

What is the setting for your property? Location: Highly urban Suburban Rural village Open countryside

When was the last time fish or plants were added to the pond?

Apart from the species that has suffered what other animals are in the pond?

Frogs  Toads  Newts  Snails  Dragonflies

Do you have fish in the pond? Yes  No

...if yes, what types of fish do you have and how many of each?

...where were the fish obtained?

...were there any fish deaths before  during  or after  
the amphibian mortality? No

...do you ever use 'fishcare' remedies in the pond? Yes No ...have they been used this year? Yes  No                        
...what brand did you use?

Section 3: About your garden...

Do you have slugs in your garden? Yes  No

Do you use any chemicals or fertilisers (including organic) in your garden?

Do use any chemicals or products (including organic) in the pond itself?

Have you found any other dead animals in your pond or garden this year (please specify species and number found)?

Section 5: Anything to add?

If you have any other comments to make or have not had space to fill in all your information please use the box below:

Section 6: About you...

Finally, please enter your details below:

Name:

Address:

Post code:

Daytime phone number:

Email address:

Sign me up for for Frogbites, Froglife's e-bulletin service.

This information about amphibian mortalities will be passed on to conservation bodies such as the Institute of Zoology, if you do not wish your personal details to be passed on please tick here .