Animal Bite Wound Assessment Sheet
Patient Information
Name:
Age:
Sex:
Date of Assessment:
Medical Record Number:
Bite Incident Details
Date & Time of Bite:
Location (body part):
Type of Animal:
Wild/Domestic:
Animal Vaccination Status:
Wound Assessment
Number of Wounds:
Depth:
Size:
Wound Type:
Wound Description:
Bleeding:
Swelling:
Redness:
Infection Signs:
Other Observations:
History & Management
Time Between Bite & First Aid:
First Aid Given:
Tetanus Immunization Status:
Rabies Immunization:
Additional Notes/Comments:
Assessed By:
Date: