Please submit the form below to report an Animal Bite incident. Person Reporting * First Name Last Name Email * Phone * (###) ### #### Date of Incident Location of Incident Case Number (if available): Victim Name First Name Last Name Victim Address Victim City Victim Phone (###) ### #### Animal(s) Involved Yes No Description of Animal(s) Animal Owner Name First Name Last Name Animal Owner Address Animal Owner City Animal Owner Phone (###) ### #### Description of Animal(s) Were the injuries sustained to a Person Animal Both No Injuries Classification of Injuries Enter your Message. Thank you! Notification of Animal Bite
