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ANIMAL BITE REPORTING FORM
DEPARTMENT OF Kentucky Revised Statute (MRS) 258.065 requires
reporting of animal bites by a provider within 12 hours of
initial assessment. PUBLIC HEALTH
AND WELLNESSJPatient
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How to fill out animal bite report form
How to fill out animal bite report form
01
Obtain the animal bite report form from the appropriate authorities.
02
Fill out your personal information, including your name, address, and contact details.
03
Provide details about the animal, such as its species, breed, and any identifying features.
04
Describe the circumstances of the bite, including the date, time, and location.
05
Include information about the bite victim, such as their name, age, and contact details.
06
Record any injuries sustained by the victim and the severity of the bite.
07
Indicate if medical attention was sought and provide details if applicable.
08
Include any additional relevant information, such as witnesses or previous incidents involving the same animal.
09
Sign and date the form to certify the accuracy of the information provided.
10
Submit the completed animal bite report form to the appropriate authorities.
Who needs animal bite report form?
01
Anyone who has been bitten or attacked by an animal, or who has witnessed such an incident, may need to fill out an animal bite report form.
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What is animal bite report form?
Animal bite report form is a document used to record details of incidents where an individual has been bitten by an animal.
Who is required to file animal bite report form?
Healthcare professionals, animal control agencies, and individuals who have been bitten by an animal are required to file animal bite report form.
How to fill out animal bite report form?
To fill out animal bite report form, you need to provide details such as date of incident, location, type of animal, severity of bite, victim's information, and treatment received.
What is the purpose of animal bite report form?
The purpose of animal bite report form is to document and track incidents of animal bites for public health and safety purposes.
What information must be reported on animal bite report form?
Information that must be reported on animal bite report form includes details about the animal, the incident, the victim, and any medical treatment received.
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