Name:

Address:

Telephone :

Location/Date:

Could you tell us the name of the site
and give a 6-figure grid reference:

Date and Time:

Weather:

Habitat:

What type of land was the snake seen on?

Woodland

Wall

Woodland Ride or Path

Grassland
(Meadow or Pasture)

Woodland Edge

Heathland

Park or Garden

Pond

Hedgerow

Embankment
(Road or Disused Rail)

Species:

Do you know what kind of reptile you saw?

Adder

Slow Worm

Grass Snake

Not Sure

If you are not sure what kind of snake you saw
please fill in the boxes in the following section:

Distinguishing Features:

To help identify your sighting could you please say if
any of the features below were visible on the reptile?

Colour: was it:

Light Grey

Brown/Gold/Grey

Brown

Grey/Brown

Gold/Brown

Markings: were any of the following markings visible?

Zigzag

Dark Stripes

Dark Sides

Yellow Collar Below The Head

Blue Spots

Butterfly "V" On Head

What was the snake doing?
(Was it basking on a rock or path,
feeding, moving from place to place etc.?)

Is there anything else about the snake
or its location you want to tell us?