Click on the map where the rabbit was located.

1. Date observed *

2. Click on the map, or type your coordinates:

Latitude *

Longitude *



3. What disease do you suspect is present? *

Rabbit Haemorrhagic Disease (RHD) (see image)

Myxomatosis (see image)

Unknown

4. Type of rabbit

Wild

Pet

Hare (not a rabbit)

5a. Breed

5b. Number at risk

5c. Number sick

5d. Number dead

6. Has this animal been vaccinated against RHDV1?

Yes

No

Unknown



7. Do you want to submit a sample? * (see instructions) No

Yes



7a. Please enter your name and postal address, and a sample kit will be sent to you



7b. Please place your rabbit in a plastic bag and label the bag (eg. Rabbit-1). Record the bag label below, and place the rabbit in a freezer until a sample kit arrives. Please submit a new record for each rabbit.



7c. Is this animal a juvenile (less than 90 days of age or less than 900 grams)

Yes

No

Unknown

7d. Sex of the animal

Male

Female

Unsure

8. Has RHDV1 K5 been released at this locality recently?

Yes

No

Unsure



9. Comments (250 character limit)



10. Email address *

