***FOR MEDICAL PROFESSIONAL USE ONLY. ***
This form to be used by MEDICAL PROFESSIONALS ONLY to report animal bites to humans. Reports filed by non-medical personnel will not be processed. If you are a non-medical professional who would like to report an animal bite, please call (805) 388-4341.
Whenever a patient is treated for any animal bite, an Animal Bite Record must be completed pursuant to Title 17, Section 2606 of the California Code of Regulations. It is the medical care provider’s responsibility to see that all required portions of this report are completed to the best of the patient’s and medical professional’s ability, and immediately submit this form to Ventura County Animal Services.
For medical providers who wish to submit this form via FAX or email, print this page, complete the form using blue/black ink, and send via FAX to (805) 388-4393 or scan and send via email to firstname.lastname@example.org with subject “Bite Report.” Medical professionals who wish to keep a copy of this information for your records, print this page before clicking the submission button at the bottom. Thank you.