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* Are you a member of Born Free USA? Yes No
If NO, are you interested to learn more? Yes No
* We are always on the look out for "activist members" (these are people who regularly help us with our campaigns). Would you like to join our email list? Yes No
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Information About The Zoo or Attraction
* Facility Type Zoo Aquarium Individual animal Circus Photo opportunity Other
Name
City
StateAlaska Alabama Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
* What was the reason for visiting the attraction?
* On a scale of 1 (lowest) to 5 (highest), how would you rate this attraction? 1 2 3 4 5
* What was your general impression?
* Did the animals look content?
Yes No
If NO, explain:
Elephant Other Bears Tiger Reptiles Gorilla Domestic animals Panda Giraffe Lion Birds Rhino Monkeys Dolphin / Orca Hippopotamus Polar Bear Zebra Leopard Fish Chimpanzee Sealion / Seal
* Did any of the animals appear to be unwell? Please give details:
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* Did you see staff members readily available to ask for help? Yes No
* Did you talk to the staff? Yes No
Were they easy to talk to, were you satisfied with their answer and the information given? Please explain:
Does the animal attraction offer other entertainment, i.e., shows, talks, amusements, etc.? Please describe:
If it was a talk, what information was shared about the animals?
Were there any informal educational facilities or formal educational programs? Describe:
Did you go to either the informal educational facilities formal program
How would you rate them? Explain:
* Were there signs outside each exhibit about the animals inside? Yes No
If YES, please describe what was on them and whether they were informative:
* Was there any contact between animals and the public (such as animal rides or petting zoos)? Yes No
What was the animal? What was the nature of the public contact?
If there was animal contact, what did you think about the warnings and explanations about safety related to it?
* Were there hand-washing facilities? Yes No Unknown
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These questions are more specifically for zoos:
Are you aware of their participation in any captive breeding programs? If so, what? Which species?
Does the zoo/attraction claim to participate in other conservation programs (such as habitat protection, antipoaching efforts, etc.)? Please describe:
Did you feel the enclosures gave the animals enough space and stimulation? Yes No
Was there anything that concerned you or that you are unsatisfied about?
Can you describe the enclosures, both indoors and outdoors? Was the ground dirt, cement, or something else? Was the barrier between you and the animal steel bars, wood fencing, or something else?
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Abnormal Behavior Observation:
You may have seen animals pacing back and forth, continually licking the bars, playing with or eating theirIf you are using this form before visiting a The abnormal behaviors described below may then
Pacing – continuous pacing back and forth.Head-bobbing – moving the head continuously up and down.Rocking / swaying – rolling motion from side to side.Circling – walking round and round, often walking in the same footprints time and time again.Neck-twisting – unnatural twisting of the neck.Bar-biting / sucking – gnawing the bars.Tongue-playing – continuous licking of the bars or wall.Vomiting – vomiting and then eating the vomit.Coprophagia – playing with or eating own feces.Over-grooming – grooming or 'hair plucking' to excess – often have bald patches.Self-mutilation or abuse – tail biting, leg chewing, head bashing, etc.
Animal:
Total time observed:5 minutes 10 minutes 15 minutes 30 minutes 45 minutes 1 hour 2 hours
Number of times observed:1 2 3 4 5 6 7 8 9 10
Your Observations:
If you have taken photographs or film footage please send them to us here at Zoo Check (zoocheck@bornfreeusa.org ) or use wetransfer.com or similar file transfer service if you have large files
I am sending you: Photographs Film footage Leaflets I am not sending additional materials
* A reminder that Born Free USA does not return film/photographs unless requested. We would welcome a small donation to cover costs if you require their return. This would cover the costs of copying and return postage. Thank you.
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Zoo Check Feedback Form: Last Step
What do you know about the future of this facility? Are expansions or renovations planned?
Would you be willing to file a formal complaint with the appropriate authorities about the conditions of the animals at this facility? We will help you through every step of the process. Yes No
If NO, would you be happy with Born Free USA filing such a complaint on your behalf? Yes No
Additional Comments:
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