Bite Incident Form

Incident Information

Was this incident against a human or animal?

Did the bite break skin?

Contact Information

Who's filling this out?

Please provide details

Relationship to PAWS

Please provide details

First Name

Last Name

Phone

Email

Address

Victim First Name

Victim Last Name

Victim Phone

Victim Email

Victim Relationship to PAWS

Please provide victim relationship details

Witness First Name

Witness Last Name

Witness Phone

Witness Email

Witness Relationship to PAWS

Please provide witness relationship details

Was anyone else present?

Please elaborate

Injury Information

Animal Species

Animal Name

Animal Number

Victim Animal Species

Please elaborate

Victim Animal Name

Victim Animal Number (if applicable)

Were other animals present/involved?

List other animal name(s) and animal number(s) (if applicable)

Did the victim seek medical attention?

Doctor / Hospital Information

Vet / Clinic Information

Please describe the appearance/location of the bite and attach photos

Note: If the bite is located in a private or sensitive area of the body, please do not include or attach a photograph. If additional documentation is required, a member of our team will contact you directly.

File 1

File 2

File 3

Additional Information

What date did the incident occur?

What approximate time?

AM/PM

Where did the bite/incident take place?

Please explain

Has the county been notified?

What county was notified? What is the Rabies Observation number?

Has the animal completed their full rabies observation?

Describe anything in the environment before and during the bite. (e.g. the presence of food, toys, bed, other animals, loud noises, etc)

Have there been other bites?

Please elaborate

Furrowed brow	Lunging	Staring
Trembling	Ears back	Hair Standing Up
Stiff Body	Vigilant darting gaze	Excessive drooling
Hiding	Retreating	Tail tucked
Sleeping	Ears Upright and Alert	Ears turns sideways
Ears pressed flat against the head	Eyes wide	Lowered body
Showing teeth	Tightened lips	Eating
Tail Stiff and Lowered

Furrowed brow	Lunging	Staring
Trembling	Ears back	Hair Standing Up
Stiff Body	Vigilant darting gaze	Excessive drooling
Hiding	Retreating	Tail tucked
Sleeping	Ears Upright and Alert	Ears turns sideways
Ears pressed flat against the head	Eyes wide	Lowered body
Showing teeth	Tightened lips	Eating
Tail Stiff and Lowered