Animal Bite/Snap QuestionnairePlease enter your email address:* First name of animal:* Last name of animal:* Species of animal: Dog Cat Other If you selected other, please indicate the species. How many times has your animal bitten or snapped at a person?*Please complete a form for each separate incident. If your animal has bitten or snapped multiple times, please complete a form for the 3 most serious incidents. Date of Incident:* MM slash DD slash YYYY Was the bite reported to Animal Control? Yes No Which jurisdiction?Please document any citations and outcome of situation. Police Department? Yes No Which jurisdiction?Please document any citations and outcome of situation. Did the person seek medical attention?If yes, please explain.Location of bites on the body:* Was the bite through clothing? Please describe. Please check the best description of the bite: Snapped only — no contact Made contact but no broken skin Pinched skin and caused bruising/raised welt but no broken skin Shallow scrape/scratch Single puncture from single bite Multiple punctures from single bite Internal injuries Deep laceration(s)/ripped skin Single puncture from single bite – describe depth of puncture: Multiple punctures from single bite – describe number and depth of punctures: Internal injuries – describe: Deep laceration(s)/ripped skin If stiches/staples were required, how many? Where did the bite occur?If other, please explain in the next section. In owner’s home In owner’s yard On street Other If other, please explain: What was the person doing before the bite occurred? Where was the person in relation to the animal? Did the animal lunge/jump/move toward the bite victim? What warning signals did the animal exhibit before biting?If other, please explain in the next section. Retreating Turning away/avoiding Growling Baring teeth Snapping Other If other, please explain: Please provide any additional details regarding this bite occurrence:Upload photo of injuries (optional).Max. file size: 50 MB.