Report created by RaptorMed (www.raptormed.com)

Missouri
Conservation
Department
Application for Wildlife Rehabilitation Permit

Permits are valid from date of issue thru December of the issuance year.
January 1st is the annual renewal date.

 
Read and complete entire application before signing. Please print.
<>Home phone:
Address:Work phone:
City, State, Zip:Cell phone:
County:Email:
 
Name and address of affiliated organization (if applicable).
<>Phone: <>
<>
County: St. Louis
FAX: 636-225-4390
Afflilation Type:
[ ] Employee
[ ] Volunteer
[X] Other - NOT FOR PROFIT
 
Please list below all degrees, training, and/or experience which applies to wildlife rehabilitation:
 
Combined 70 years experience in raptor/heron rehabilitation.
 
 
Description of facilities (include size and number of cages and/or pens, and building dimensions if applicable):
 
We have a hospital dedicated to intensive care of patients. Twelve 8'x8'x16' mews and a 20'x20'x240' flight cage all dedicated to patient exercise before release to the wild.
 
 
List species of wildlife to be rehabilitated:
 
Raptors and herons
 

NOTE: A federal permit from the United States Fish & Wildlife Service is REQUIRED for the rehabilitation of endangered or migratory wildlife, including migratory birds native to Missouri. For a list of migratory birds, please visit http://www.fws.gov/migratory/birds/RegulationsPolicies/mbta/mbtintro.html. A Missouri Wildlife Rehabilitation permit does not relieve you of compliance with any other state or federal regulations.
List federal permit number (if applicable) and expiration date:  
Permit #<>
Expiration3-31-2020
 
List names of associates who will capture, transport, and assist in the rehabilitation of wildlife. If you are not a veterinarian, you MUST list the name of a veterinarian below.
Dr. Stacey SchaefferDr. Erik Siebel-Spath
Hills Veterinary ClinicHills Veterinary Clinic
7001 Hampton Ave.7001 Hampton Ave.
St. Louis, MO 63109St. Louis, MO 63109
314-353-3444314-353-3444
This is not a permit and does not entitle applicant to operate.

Applicant's signature: ______________________________ Date: <>
Mail completed application to: Missouri Department of Conservation
Permit Serives, ATTN: Rehab
PO Box 180
Jefferson City, MO 65102

Do not write in the space below - official use only
[  ] Approved     [  ] Dispproved
Conservation agent:________________________
County:________________________
Date:________________________