Bexar County Forms

2. This report for is animal on human rabies exposure. If an animal broke skin by teeth or nails, then by law then this report must be filled out to the best of your ability.
4. Person Bit
6. First Name*
7. Last Name*
9. Parent, Guardian, or Custodian of The Minor
11. Address*
13. City*
14. State*
15. Zip*
17. Phone Number*
18. Date of Birth*
    Date of Birth
19. Gender*

    1. Male
    2. Female
21. Incident Information
23. Date & Time of Incident*
    Date & Time of Incident

    Date & Time of Incident
24. Location of Incident*
26. Injured Body Part*
27. Severity of Injury*

    1. Mild
    2. Moderate
    3. Severe
28. Type of Injury*

    1. Puncture
    2. Laceration
    3. Scratch
30. Details of What Happened*
32. Animal*

    1. Owned

    1. Stray
33. Species*
34. Breed
35. Color*
37. Age
38. Sex

    1. Male
    2. Female
    3. Unknown
39. Proof of Vaccination

    1. Yes
    2. No
    3. Unknown
41. Owner Information
43. Full Name
45. Address
47. City
48. State
49. Zip
51. Phone Number
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field