Tick Recording Scheme –Wildlife
Name of person submitting tick/s
Organisation represented
Telephone number
Email address
Date of collection
Animal specimen was collected from
(hedgehog, bat, deer etc)
Location animal was collected
(grid reference, postcode, town)
Local habitat in which animal was
collected
(woodland, pasture, urban area etc)
Any further information/notes
(health status of animal, unusual
characteristics, infestation level etc)
Return completed forms to: Tick Recording Scheme, Public Health England, Porton Down, Salisbury, SP4 0JG. See
Health Protection Services pages at www.gov.uk/phe for postage instructions and more details or email us at
Tick@phe.gov.uk
IMPORTANT: By submitting this form I agree that the information and/or tick specimens I have provided may be anonymously used
for research purposes. Names and contact details of data suppliers will be used for administration and verification purposes only. All
data collected will be stored and handled securely in compliance with the 1998 Data Protection Act.
Tick Recording Scheme –Wildlife
Name of person submitting tick/s
Organisation represented
Telephone number
Email address
Date of collection
Animal specimen was collected from
(hedgehog, bat, deer etc)
Location animal was collected
(grid reference, postcode, town)
Local habitat in which animal was
collected
(woodland, pasture, urban area etc)
Any further information/notes
(health status of animal, unusual
characteristics, infestation level etc)
Return completed forms to: Tick Recording Scheme, Public Health England, Porton Down, Salisbury, SP4 0JG. See
Health Protection Services pages at www.gov.uk/phe for postage instructions and more details or email us at
Tick@phe.gov.uk
IMPORTANT: By submitting this form I agree that the information and/or tick specimens I have provided may be anonymously used
for research purposes. Names and contact details of data suppliers will be used for administration and verification purposes only. All
data collected will be stored and handled securely in compliance with the 1998 Data Protection Act.