Animal Bite Form
What day did the animal bite happen?
What time did the incident happen?
What type of animal bit?
Description of animal that bit.
Did the animal bite a human or a domestic animal?
Human
Dog
Cat
Name of animal that bit
Was the animal that bit vaccinated for rabies?
Yes
No
Unknown
What date was the animal vaccinated?
What clinic vaccinated the animal?
Address where the bite occured
Name of person or animal bitten
Age of person bitten.
Is the person bitten male or female?
What part of the person or animal's body was bitten?
Name of parent or guardian if person bitten is a minor
Phone number of victim, or parent/guardian.
Address of Victim or victim animal
Name of the owner of the animal that bit.
Address of the animal that bit.
Phone Number of the owner of the animal that bit
Please describe how the incident happened