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The purpose of this form is to collect information about animal bites in the context of a rabies control investigation. It should be used by county health department staff when conducting an animal bite investigation. Case Number: Provide the number assigned to the case being investigated.
Report an animal bite to FDOH Hillsborough County: Scan the QR code with your mobile device. or Click here to report an animal bite online. Need another way? Download the Animal Bite Report form and fax it to the victim’s county of residence. Hillsborough Fax: 813-272-7242. Manatee Fax: 941-750-9364. Pasco Fax: 352-521-1435
This form is to be completed for each person for whom PEP is recommended in Florida in order to help evaluate the Rabies Prevention and Control Program.
ANIMAL BITE REPORT FORM. Florida Administrative Code (FAC) 64D-3.002(1)(a), Communicable Diseases, requires that any animal bite to a human by a potentially rabid animal or nonhuman primate, be reported to the local county health department within 72 hours of recognition.
The purpose of this form is to collect information about animal bites in the context of a rabies control investigation. It should be used by county health department staff when conducting an animal bite investigation. Case Number: Provide the number assigned to the case being investigated.
HUMAN EXPOSED. ANIMAL BITE REPORT and RABIES INVESTIGATION (Bite, Scratch, Saliva in wound or mucous membrane) Reporting entity must complete all fields. Grayed fields are for FDOH-Franklin use only. Date Reported: Initial report received by: 1a. HD Case Number: 1b.
ANIMAL BITE REPORT RABIES CONTROL INVESTIATION. 1. Name of Person Bitten (Last, First) 3. Date of Birth. 4. Telephone. 5. Address of Person Bitten.
