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NORTH CENTRAL PUBLIC HEALTH DISTRICT ANIMAL BITE REPORT FORM 419 East 7th St, The Dallas, OR 97058 Phone: 5415062600 Fax: 5415062601 Person bitten will complete section 13. 1. Bitten Person (completed
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How to fill out person bitten will complete
How to Fill Out "Person Bitten Will Complete":
01
Start by gathering all necessary information about the person who was bitten. This may include their full name, date of birth, contact information, and any relevant medical history.
02
Next, provide details about the incident. Specify the date, time, and location of the bite, as well as the type of animal or insect involved if known.
03
Describe the circumstances surrounding the bite, such as whether it occurred at home, outdoors, or at a specific event. Include any information about the animal's behavior or provocation, if applicable.
04
Document the initial actions taken after the bite. This may involve washing the wound, applying first aid, or seeking medical attention. Be sure to mention any treatments or medications administered.
05
Record any symptoms experienced by the person bitten, both immediately after the incident and in the following days or weeks. This can help healthcare professionals assess the severity of the bite and its potential complications.
06
If the person sought medical attention, provide details about the healthcare facility visited, including the name, address, and contact information. Include information about any medical professionals consulted and their recommendations for further care.
07
Mention any follow-up appointments, tests, or treatments scheduled as a result of the bite. This may include vaccinations, rabies shots, or wound check-ups.
08
If applicable, include details about any insurance claims or legal actions related to the bite. Provide the name of the involved insurance company or legal representative, along with any claim or case numbers.
09
Finally, sign and date the "Person Bitten Will Complete" form, ensuring all information is accurate and complete.
Who Needs "Person Bitten Will Complete":
01
Individuals who have been bitten by an animal or insect and seek medical attention are required to fill out the "Person Bitten Will Complete" form. This form helps healthcare professionals gather crucial information about the bite incident, including details about the person, the bite itself, initial actions taken, and any subsequent medical treatments or follow-ups.
02
The form is also valuable for insurance purposes, as it provides essential documentation for potential claims related to the bite. Legal representatives and insurance companies may request the "Person Bitten Will Complete" form to assess liability and coverage.
03
Additionally, public health agencies and animal control departments may request this form to monitor and investigate animal bites, particularly if there are concerns about rabies or public safety. Properly completed forms assist in compiling accurate statistics and implementing necessary measures to prevent future incidents.
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What is person bitten will complete?
Person bitten will complete a incident report form.
Who is required to file person bitten will complete?
The person who was bitten is required to file the incident report.
How to fill out person bitten will complete?
The person bitten should provide details of the incident, such as date, time, location, and description of the bite.
What is the purpose of person bitten will complete?
The purpose of the incident report is to document the bite and ensure proper follow-up action is taken.
What information must be reported on person bitten will complete?
The information reported should include details of the person who was bitten, the circumstances of the bite, and any medical treatment received.
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