NAHMS-238 Urban Chicken Questionnaire

National Animal Health
Monitoring System
Animal and
Plant Health
Inspection
Service

2150 Centre Ave Bldg B
Fort Collins, CO 80526

URBAN CHICKEN QUESTIONNAIRE

Veterinary
Services

Form Approved
OMB Number 0579-XXXX
Expires

The purpose of this survey is to learn more about chickens living in urban areas.
Your response is confidential, anonymous, and voluntary. Thank you for your help!
You must own chickens and reside in one of the following zip codes to complete this survey:
Zip code list here.

Additionally, if you live in a single-family home, it must be on less than 1 acre of land. If your chickens live in a
community co-op there is no acreage limitation, but the co-op must be located in the above zip codes.

Section A: General Management
1. How many of the following types of birds have you had at your home (or at the
community co-op) during the previous 12 months?
a. Chickens: table egg breeds (e.g., Leghorn, Plymouth Rock, Rhode Island Red)....
b. Chickens: meat breeds (e.g., Cornish, Sex-links)....................................................
c. Chickens: game fowl (e.g., Kelso, Hatch, Claret) ....................................................
d. Chicken: others (e.g., show/exhibition, Silkie, Sebright, Ancona)............................
e. Turkeys .....................................................................................................................
f. Ducks/other water fowl (e.g., geese, swans) ...........................................................
g. Pigeons, doves, or game birds (e.g., quail, pheasant).............................................
h. Guinea fowl ..............................................................................................................
i. Pet birds (breeds not used for food and usually housed in cages
in the home, e.g., parrots, cockatiels, parakeets, finches, canaries) .......................
j. Other species of birds (specify: ______________________________) .................
2. What is the maximum number of chickens you have had at your home (or at the
community co-op) at one time during the previous 12 months?.....................................

_____ head
_____ head
_____ head
_____ head
_____ head
_____ head
_____ head
_____ head
_____ head
_____ head
_____ head

3. Which of the following best describes the location where your chickens are kept?
[Check one only.]
1 At a community co-op
2 At your home (single-family home on less than 1 acre)
3 At your home (multifamily dwelling [e.g., apartment or condo])
4 Other (specify: __________________________________)
4. Approximately how far (in miles) is this feed store from the location
where you keep your chickens? .....................................................................................
5. What is the approximate distance from the location where your
chickens are kept to the nearest premises with poultry?......... _____ miles OR ____ feet
6. Do any of your chickens or other birds have outside access and the ability
to leave the property (even if they do not)? ....................................................................
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to
resond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this
information collection is 0579-XXXX. The time required to complete this information collection is estimated to average 0.25
hours per response, including the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information collected.

_____ miles

4

Don’t know

1 Yes

3

No

NAHMS-238
July 2010
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The remaining questions refer to chickens only.
7. How often do you house any chickens inside your home? ...........

1

Always

8. During the previous 3 months, how often did you see the following
animals or evidence of the following animals in the chicken area?
a. Wild waterfowl (e.g., ducks, geese) ...........
1 Daily
2 Weekly
b. Wild birds other than waterfowl ..................
1 Daily
2 Weekly
c. Rodents (rats or mice)................................
1 Daily
2 Weekly
d. Wild animals other than rodents (e.g., feral cats,
raccoons, foxes, skunks, possums, etc.) ...
1 Daily
2 Weekly
e. Neighbor’s chickens and/or other birds......
Daily
1
2 Weekly
f. Pet dogs or cats .........................................
Daily
1
2 Weekly

2

Sometimes

Monthly
Monthly
3 Monthly

4

3

4

Monthly
3 Monthly
3 Monthly

Never

Rarely or Never
Rarely or Never
4 Rarely or Never

3

3

3

Rarely or Never
4 Rarely or Never
4 Rarely or Never
4

9. Are any of the following rodent control methods used for the chicken area?
a. Bait ...........................................................................................................................
b. Traps/sticky tape ......................................................................................................
c. Dogs/cats .................................................................................................................
f. Other (specify: _________________________________) .....................................

1 Yes

No
No
3 No
3 No
3

1 Yes

3

1 Yes
1 Yes

10. Did you have any of the following problems in your chickens
during the previous 3 months?
a. Diarrhea....................................................................................................................
b. Respiratory (nasal/ocular discharge, cough/rattle/sneeze, “snicking”) ....................
c. Neurologic (falling over, weakness, trembling) .......................................................
d. Weight loss...............................................................................................................
e. Feed refusal/depression (droopy birds) ..................................................................
f. Sudden decreased production (egg laying, hatchability, weight gain).....................
g. Unexplained death loss ............................................................................................
h. External parasites (lice/mites) ..................................................................................
i. Lameness/leg problems ...........................................................................................
j. Other (specify: ____________________________) ...............................................

1 Yes

No
No
3 No
3 No
3 No
3 No
3 No
3 No
3 No
3 No
3

1 Yes

3

1 Yes
1 Yes
1 Yes
1 Yes
1 Yes
1 Yes
1 Yes
1 Yes

11. During the previous 12 months, how many times did you take any chickens
to a veterinarian? [If none, enter 0.] ................................................................................

_____ times

12. Did your chickens receive any treatments, medications, or vaccines
during the previous 12 months?...................................................................................

1 Yes

3

No

13. How important to you are the following sources of
chicken health information?
Very
Important
a.
b.
c.
d.
e.
f.

Veterinarian (private practitioner)...............................
Extension service .......................................................
Other producers .........................................................
Feed store ..................................................................
Magazine/journals ......................................................
Internet ......................................................................

Somewhat
Important

Not
Important

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

1

2

3

14. Do you feed your chickens table scraps? ......................................................................

1 Yes

3

No

Section B: Chicken Movement
1. How many times during the previous 12 months were additional chickens placed into
your flock (not including those hatched on-site)? [If none, enter 0.]...............................

_____ times

[If Item 1 = ZERO, SKIP to Item 3.]
2. How many times did you obtain chickens from each of the following sources during
the previous 12 months? [If none, enter 0.] For each source that was used, approximately how
far (in miles) was the source from the location where you keep your chickens?
2

a.
b.
c.
d.
e.
f.
g.

Local hatchery
Private individual (e.g., friend, neighbor)
Poultry wholesaler or dealer
Fair or show
Feed or farm store
Mail order or Internet
Other (specify: ___________________________)

_____ times
_____ times
_____ times
_____ times
_____ times
_____ times
_____ times

3. Did you sell or give away any live chickens during the previous 12 months? ................

_____ miles
_____ miles
_____ miles
_____ miles
_____ miles
_____ miles
_____ miles
1 Yes

3

No

[If Item 3 = NO, SKIP to Item 5.]
4. How many times did you sell or give away chickens in each of the following ways during
the previous 12 months? [If none, enter 0.] For each method, approximately how far (in miles) did the
chickens travel to their destinations?
a. Live-bird market
_____ times
_____ miles
b. Private individual (e.g., friend, neighbor)
_____ times
_____ miles
c. Poultry wholesaler or dealer
_____ times
_____ miles
d. Fair or show
_____ times
_____ miles
e. Feed or farm store
_____ times
_____ miles
f. Other (specify: ___________________________)
_____ times
_____ miles
5. During the previous 12 months, how often did you take any of your chickens to a
location (e.g., fair, show) where other birds were present and then return them to
your flock? [If none, enter 0.] ..........................................................................................

_____ times

6. During the previous 12 months, approximately how many times did you sell or
give away any hatching or table eggs? [If none, enter 0.] ..............................................

_____ times

Section C: Biosecurity
1. How often do you require the following practices for people
entering the chicken area?
a. Use of footbath before entry..........................................
b. Scrub boots/shoes before entry ....................................
c. Wear disposable boot or shoe covers...........................
d. Wear dedicated clothing or change clothing
before entering ............................................................
e. Wash hands before handling the chickens ...................
f. Wash hands after handling the chickens ......................

Always
Always
1 Always

Sometimes
Sometimes
2 Sometimes

Never
Never
3 Never

1

2

3

1

2

3

Always
Always
1 Always

Sometimes
Sometimes
2 Sometimes

Never
Never
3 Never

1

2

3

1

2

3

2. How many times did the following types of people enter your chicken area
during the previous 12 months? [If none, enter 0.]
a. Private veterinarian ..................................................................................................
b. University veterinarian or cooperative extension agent ...........................................
c. Customer (private individual) purchasing birds, meat,
eggs, or other bird products .....................................................................................
d. Bird wholesaler, buyer, or dealer (including live-bird market owner) .......................
e. Service person for facilities or equipment (e.g., meter reader,
plumber, electrician, etc.) .........................................................................................
f. Nonbusiness visitors (e.g., school groups, friends, or neighbors) ...........................

_____ times
_____ times
_____ times
_____ times
_____ times
_____ times

Section D: Slaughter and Death Loss
1. Were any of your chickens slaughtered or sold for slaughter
for human consumption during the previous 12 months?  .............................................

1 Yes

3

[If Item 1 = NO, SKIP to Item 3.]
2. During the previous 12 months, how many times were chickens slaughtered
3

No

in each of the following ways? [If none, enter 0.]
a. Home slaughtered by yourself or family member ....................................................
b. Mobile slaughter facility that came to your house ....................................................
If a mobile slaughter facility was used, how far did it travel to your chicken coop? .
c. Chickens transported to slaughter facility ................................................................
d. Other method (specify: ___________________________) ....................................

_____ times
_____ times
_____ miles
_____ times
_____ times

3. Not counting birds slaughtered for human consumption, how many
of your chickens died or were euthanized during the previous 12 months?...................

_____ head

[If Item 3 = ZERO, SKIP to Section E.]
4. How many died from the following causes:
a. Predators?................................................................................................................
b. Illness/disease?........................................................................................................
c. Injury?.......................................................................................................................
d. Old age? ...................................................................................................................
e. Other known cause? (specify: ______________________________) ...................
f. Unknown cause?......................................................................................................

_____ head
_____ head
_____ head
_____ head
_____ head
_____ head

5. Which of the following was the primary method of disposing of dead chickens?
[Check one only.]
1 Incinerated
5 Composted
2 Buried on premises
6 Taken to a landfill or put in trash
3 Renderer picked up
7 Fed to other animals or left for scavengers
Carcass
taken
to
renderer
4
8 Other disposal method (specify: _____________________)

Section E: About You
1. On a scale of 1 to 5 with 1 being not important and 5 being extremely important,
how important are the following reasons for you to have chickens?
[Check one number only in each row.]
Not Important
→
Extremely Important
1
2
3
4
5
a. Family tradition
_____
_____
_____
_____
_____
b. Fun/hobby
_____
_____
_____
_____
_____
c. Income
_____
_____
_____
_____
_____
d. Food source
_____
_____
_____
_____
_____
e. Food quality (e.g., freshness, health)
_____
_____
_____
_____
_____
f. Concerns about animal welfare
_____
_____
_____
_____
_____
g. Concerns about the environment
_____
_____
_____
_____
_____
h. Lifestyle
_____
_____
_____
_____
_____
i. Social interactions (e.g., 4-H, clubs)
_____
_____
_____
_____
_____
j. Learning experience for kids
_____
_____
_____
_____
_____
k. Other reasons to have birds
(specify: ________________________)
_____
_____
_____
_____
_____
2. How long (in months or years) have you or your family raised chickens? .....................______
months

OR

_____
years

3. Do any children under the age of 18 live in your household? ........................................

1 Yes

3

No

4. Do you or your family belong to any type of poultry or avian
association (include 4-H, FFA)? .....................................................................................

1 Yes

3

No

5. Have you heard of USDA’s “Biosecurity for the Birds” educational campaign?.............

1 Yes

3

No

Thank you for your time!

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