Backyard Poultry Biosecurity Inspection Form

Owner & Location Details

Owner Name

Property Address

Contact Number

Inspection Date

Inspector Name

Flock Information

Species Kept

Number of Birds

Age Range of Birds

Biosecurity Practices

Are there measures to prevent wild birds accessing poultry?

Yes No

Is clean water supplied daily?

Yes No

Are visitors restricted from accessing the poultry area?

Yes No

Is proper hand washing facility available?

Yes No

Are separate footwear/clothing used in poultry areas?

Yes No

Health & Disease Management

Any recent illness or deaths in the flock?

Yes No

If yes, please describe symptoms or issues

Are sick birds isolated from the rest?

Yes No

Any recent medication or vaccination given?

Additional Notes/Comments

Inspector's Signature