Animal Bite/Scratch Laboratory Incident Report
1. Incident Details
Date of Incident
Time of Incident
Location
2. Person Involved
Name
Job Title
Department
3. Animal Involved
Species
Animal ID/Tag
4. Description of Incident
Describe how the incident occurred (including activity at the time):
Type of Exposure
Bite
Scratch
Other
Body Part(s) Affected
5. Immediate Actions Taken
First aid/treatment provided:
6. Reporting and Follow-up
Who was notified?
Follow-up actions/recommendations:
7. Reporter Information
Reporter's Name
Date Submitted