Plant Survey Form Fill out this form to submit your rare plant survey. If you would prefer to print out, email, or fax your plant survey, you may download the form as a Word document. Email that form to natural.heritage@ncdcr.gov or mail to: N.C. Natural Heritage Program; MSC 1651; Raleigh, NC 27699-1651. We can no longer accept sketches/maps of areas online due to security concerns. Please follow the directions sent to you via email to submit your sketch/map in addition to completing this form. Download This Form Fields marked with an asterisk (*) are required. Indicates required field Person Making this Report (Name) * Person Making this Report (Name) First Name Last Name Agency/Affiliation Email address Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Number Observers Scientific Name Common Name Survey Date EO Number (if updating existing EO) County Coordinates (if known): If coordinates given, indicate coordinate system and datum (State Plane 1927 or 1983, UTM, etc.) Elevation Site Name (If this is within previously identified site:) Site Location and Directions Number of Individuals Define Individual (stem, clump, etc.) Size of Area in Which Population Occurs Estimate whether the entire population was surveyed, or only a portion Population Viability Comments If failed to find, indicate the thoroughness of the survey. Phenology (include % or # in each stage: vegetative, bud, flower) Evidence of Reproduction Fruit Seedlings Clonal/Vegetative Reproduction Comments Habitat (N.C. N.H.P. natural community name and description, if known; include quality, soils, geology, etc.) Associated Species Invasive species noted & degree of threat from invasive species or other threats If the population is within a Right-of-Way, does suitable habitat exist outside Right-of-Way? Topographic Position (examples: crest, mid slope, alluvial, etc) Moisture Regime (examples: inundated, dry, seasonally wet, etc) Light (examples: open, woodland, closed canopy, etc) Other Information Specimens Collected? (permits are required for federal or state listed species) Collection # Repository Email Phone
Plant Survey Form Fill out this form to submit your rare plant survey. If you would prefer to print out, email, or fax your plant survey, you may download the form as a Word document. Email that form to natural.heritage@ncdcr.gov or mail to: N.C. Natural Heritage Program; MSC 1651; Raleigh, NC 27699-1651. We can no longer accept sketches/maps of areas online due to security concerns. Please follow the directions sent to you via email to submit your sketch/map in addition to completing this form. Download This Form Fields marked with an asterisk (*) are required. Indicates required field Person Making this Report (Name) * Person Making this Report (Name) First Name Last Name Agency/Affiliation Email address Address Address Address 2 City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Number Observers Scientific Name Common Name Survey Date EO Number (if updating existing EO) County Coordinates (if known): If coordinates given, indicate coordinate system and datum (State Plane 1927 or 1983, UTM, etc.) Elevation Site Name (If this is within previously identified site:) Site Location and Directions Number of Individuals Define Individual (stem, clump, etc.) Size of Area in Which Population Occurs Estimate whether the entire population was surveyed, or only a portion Population Viability Comments If failed to find, indicate the thoroughness of the survey. Phenology (include % or # in each stage: vegetative, bud, flower) Evidence of Reproduction Fruit Seedlings Clonal/Vegetative Reproduction Comments Habitat (N.C. N.H.P. natural community name and description, if known; include quality, soils, geology, etc.) Associated Species Invasive species noted & degree of threat from invasive species or other threats If the population is within a Right-of-Way, does suitable habitat exist outside Right-of-Way? Topographic Position (examples: crest, mid slope, alluvial, etc) Moisture Regime (examples: inundated, dry, seasonally wet, etc) Light (examples: open, woodland, closed canopy, etc) Other Information Specimens Collected? (permits are required for federal or state listed species) Collection # Repository Email Phone