Animal Bite/Attack Report | Sedgwick County, Kansas

Bite/Attack description

Victim Of (required)

Bite

Scratch

Attack

Exposure

Bite/Attack Description (required)

Simple

Severe

Provoked

Unprovoked

Victim Details

Victim Name (required)

Address (required)

City (required)

Zip code (required)

Work Address

Work City

Work Zip Code

Phone Number (required)

Age (required)

Date of Bite Occured (required)

Time of Bite Occured (required)

Address/Intersection where bite occured (required)

Location of bite on body (required)

Did you receive medical treatment

Yes

Describe the incident(What happened)

Owner Details

Owner Name

Owner Address

Owner City

Owner Zip code

Owner Work Address

Owner Work City

Owner Work Zip code

Owner Home Phone

Owner Work Phone