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* 1. Please list all 3 assessor names and their respective positions

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* 2. Are you assessing an individual or group?

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* 3. What is the species or group name?

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* 5. Which taxonomic group are you assessing?

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* 6. Please list the animal ZIMS#/Group #

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* 7. What event is dictating this assessment?

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* 8. Nutrition

  0 1 2 NA Not able to assess
Has each animal consistently been provided an appropriate diet and access to clean, fresh water?
Has the diet been consistently provided in a way to encourage species appropriate feeding behavior?
Has there been consistent evidence that all animals are adequately consuming food?

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* 9. Environment

  Acceptable Questionable Unacceptable NA Not able to assess
Has there been evidence that habitat space provided appropriate resource availability?
Has there been consistent evidence that the animal uses habitat space?
Has there been evidence that indoor and/or holding space provided appropriate resource availability?
Has there been consistent evidence that the animal uses holding space?
Has there been evidence that the environment provides appropriate resources for the animal to regulate body temperature and avoid environmental elements?
For indoor and/or holding spaces: Has the air quality been consistently and appropriately maintained for the species/individuals?
For indoor and/or holding spaces: Has the lighting been conducive to species-specific and/or individual needs?
Has the noise level been conducive to species-specific and/or individual needs?
Have all water sources been monitored for appropriate water quality?
Has there been evidence of inappropriate standing or pooling water?
Have there been any hazards not identified by previous questions?

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* 10. Health

  Acceptable Questionable Unacceptable NA Not able to assess
Has the animal’s weight/BCS consistently appeared to be within the normal range?
Has the animal’s outward physical appearance consistently been species and seasonally appropriate?
Have the animal's movement patterns been consistently species appropriate?
Have the fecal form and output and urinary appearance and output been consistently species appropriate?
Has the animal participated in voluntary health care? If voluntarily participation was not possible, did equipment and staff experience allow for safe and timely capture/restraint of animal?
Were medical conditions experienced documented, diagnosed & treated in an appropriate and effective manner?
Did health concerns limit positive welfare?

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* 11. Behavior

  Acceptable Questionable Unacceptable NA Not able to assess
Has the animal demonstrated appropriate frequency and diversity of natural behaviors?
Has the animal consistently lacked evidence of self-destructive, aggressive or abnormal behaviors (e.g., stereotypy)?
Has there been an approved enrichment program that has been followed and documented?
Has there been an active training program based upon positive reinforcement best practices?

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* 12. Choice and Control

  Acceptable Questionable Unacceptable NA Not able to assess
Has the animal consistently had the choice to shift/crate/secure without unreasonable negative consequences?
Has the animal participated in voluntary training for behavioral management for physical health or mental stimulation without unreasonable negative consequences when choosing to not participate?
Has the animal had the choice to engage socially in a species appropriate manner?
Has the animal exhibited the ability to cope with guest disturbance or other environmental stressors?

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* 13. Affective/Mental state

  Acceptable Questionable Unacceptable NA Not able to assess
Has the animal consistently demonstrated behaviors that are strong indicators of positive welfare?
Has there been a consistent lack of evidence of negative welfare?

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* 14. General notes or comments?

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