* Required
SCGRR Dog Bite Incident Report
All dog bite incidents should be documented with SCGRR - whether reported or not. In addition to the required information, photographs of injuries should be emailed to [email protected]
* Person Documenting Incident (Name, Phone, Email):
* Dog Name:
* Dog's SCGRR ID #:
 Number, no commas or symbols
Status at Time of Bite:

* Rabies Vaccine Details (date, manufacturer, etc.)
* Date/Time of Bite:
* Location of Incident (address, cross streets, county):
* Who was Bitten?

Human Bite: Name, Age, Address, Phone, Email of Person Bitten:
Human Bite: Parent's Name / Phone if Minor Bitten:
Human Bite: Person's relationship to dog and to SCGRR:
Human Bite: Tetnus Shot Date / Within last 10 yrs:
Dog Bite: Name, Age, Indentification of Dog Bitten:
Dog Bite: Owner's Name, Address, Contact for Dog Bitten
* Type of Exposure (skin contact, bite, scratch, tear):
Skin broken?

Drew Blood?

* Was there more than one wound? If so, how many?:
* Was there more than one bite? If so, how many?:
* Location of Wound(s):
* Describe details leading up to the incident and what occurred:
* Did the dog bite and let go or hold on?
If held on, for approximately how long? What did it take for the dog to release?
* Did the dog shake it's head / tear?
Was treatment provided?

If treated, describe. Self-treated or doctor / ER visit?
Was Animal Control Called?

If AC called: contact information, case # and any instructions:
Were the police called?

If police called: contact information, case # and instructions:
Outcomes as result of Incident:

If assessed: Trainer/Behaviorist contact information. Should be CPDT-KA credentialed with assessment documents and uploaded (email to [email protected]):
If confined: Location, contact, start/end dates, quarantine period?
If euthanized: date/time, veterinarian contact info:
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