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Bite Report (Dog to Animal)

 

Please use the below form to report an animal bite that caused injury to another animal. To notify San Diego Humane Society Law Enforcement of an animal biting a human, please use this form

To fill out the paper form, please print this PDF file. 

 


 
Please provide your contact information:
  This form was completed by:

*

Name:

 

 

   

*

 

 

City/State/ZIP:

 

    

*

 

Date of Birth:

 

 


 

Bite Information
*

*  


 
Question - Not Required - Date of Bite:




*
Question - Required - Did the Bite Break Skin:


 
Circumstance of Bite
*

 

Animal Owner Information
   


   


   


   


*
Question - Required - State:

*  


   


 
Animal Description Information

Please describe te animal that caused the injury. 

   


   


 
Question - Not Required - Sex of Animal:


   


   


   


 

* Are feilds we need filled out before you can submit this form. 

   Please leave this field empty