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EKLER 

 

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Ek 1 

 

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TULAREMİ ANKET FORMU 

Adı – Soyadı: 

 

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Av hayvanı: Yeme:Var ( ) Yok ( )  Temas (temizlik, dokunma, kesme vb):                      

Var ( )Yok ( ) 

Fare ile temas (ölü veya canlı): Var (  ) Yok (  ) 

Farelerde artış: Var (  )Yok (  )  Varsa evde (  ), çevrede (  ), diğer………………….. 

Kemirici dışkı, idrar vb gibi hayvan atıklarına rastlama: Var (  ) Yok (  )  

Varsa nerelerde? ahırda (  ) evde (  ) mutfakta (  ) çevrede (  ) 

Kemirici hayvan ölüsü görme: Var (  ) Yok (  )  

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Çevreden su içme: Var (  ) Yok (  ) Varsa nerelerden? Göl (  ), dere (  ), pınar (  ), diğer 

…….. 

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Ev içinde hayvan besleme: Var (  ) Yok (  ) Varsa ne tür? Kedi (  ), köpek (  ), 

diğer…… 

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diğer…… 

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ayda:…………… 

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Ek 2 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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