Animal Bite/Snap Questionnaire - Seattle Humane

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Animal Bite/Snap Questionnaire
Please 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.

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