NYSWRC 
New York State Wildlife Rehabilitator List Signup

Complete this form to submit your name to our on-line list of New York State rehabbers.   If you are already listed and just need to change something you don't need to fill out this form, just send an e-mail to our webmaster

This form is for wildlife rehabilitators located in New York State only. 

Just complete this form and click on SUBMIT when ready to send.   

Name
Email Address
Are you affiliated with a local not-for-profit wildlife rehabilitation organization or center?
Enter the name of your  organization or center 
Would you like to add a link to your own website or website of your organization?
Phone
Alternate Phone
Town
County
DEC Region
State License Number
Federal License Number
State License Type Assistant
Class 1
Class 2
Select all that apply RVS Certified?
Oil Spill Training?
License to Collect and Possess?
What species of animals do you accept? Large Mammals
Small Mammals
Raccoons
Skunks
Bats
Raptors
Song Birds
Waterfowl
Game Birds
Reptiles/Amphibians
Non-Migratory Birds (European starlings, pigeons & house sparrows.)
Other information regarding animals you accept
Do you have any special knowledge or skills you are willing to share? (ie, I can provide educational talks to scout groups, or I can provide squirrel information to other rehabilitators)

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