Kern County Animal Services
Kern County, California
Animal Bite Form
To Properly Investigate The Bite, All Information Must Be Filled In
* Denotes Required Field
Person Completing This Form
* Name: * Email Address:
Place Occurred
* Street and City Where Bite Occurred:
* Explain How The Bite Occurred:
Bite Victim Information
* Victim Name: * Part of Body Bitten:
Date Of Birth: Extent Of Injury:
* Street Address: * Date Bitten:
* City, State, Zip: Date Treated:
* Phone Number:    
Treating Physician: Physician Phone Number:
Animal Information
* Animal Breed: * Color Of Animal:
Sex Of Animal: Animal Name:
Animal Owner Information
Animal Owner Name: City, State, Zip:
Street Address: Phone Number: