Wildlife Rehabilitation Release Form
Animal Information
Species:
Age (if known):
Gender:
Date Admitted:
Date of Release:
Location of Release:
Rehabilitator Details
Name:
License/Permit Number:
Organization (if applicable):
Reason for Release
Condition at time of release:
Notes about animal’s behavior or physical state:
Release Confirmation
I hereby confirm that the animal listed above has been rehabilitated to the best of my ability and is deemed fit for release into the wild.
Rehabilitator Signature:
Date:
Witness Signature:
Date: