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A community approach to dog bite prevention - American Veterinary ...

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Appendix 3<br />

Recommended data elements for reports of <strong>dog</strong> <strong>bite</strong>s<br />

Data element<br />

Comment<br />

Notifications of <strong>dog</strong> attacks on humans. . . A card or telephone report <strong>to</strong> be<br />

submitted by those providing<br />

care <strong>to</strong> the human victim<br />

Name of victim<br />

Address of victim<br />

Telephone (home and work)<br />

Parent contact information<br />

(if a minor)<br />

Incident date and time<br />

Reported <strong>to</strong> whom<br />

Date and time of report<br />

Notifications of <strong>dog</strong> attacks on animals . . A card or telephone report <strong>to</strong> be<br />

submitted by those providing<br />

care <strong>to</strong> the animal victim<br />

Owner of victim<br />

Type of victim<br />

Address of owner<br />

Telephone (home and work)<br />

Incident date and time<br />

Name and address of owner<br />

or cus<strong>to</strong>dian of attacking <strong>dog</strong><br />

Reported <strong>to</strong> whom<br />

Date and time of report<br />

For animal control investigations<br />

Agency information<br />

Case number<br />

Report date and time<br />

Incident date and time<br />

Who reported the case<br />

Report received by<br />

Location of incident<br />

Victim information<br />

Name<br />

Breed (if animal)<br />

Age and date of birth<br />

Sex<br />

Address<br />

Telephone (home and work)<br />

Parent contact information (if minor)<br />

Rabies immunization status (if animal)<br />

Owner information<br />

Name<br />

Age and date of birth<br />

Sex<br />

Address<br />

Telephone (home and work)<br />

Data element<br />

Comment<br />

Dog information<br />

Name<br />

Breed . . . . . . . . . . . . . . . . . . . . . . . . Indicate by whose designation<br />

(eg, owner report, animal control<br />

officer, law enforcement officer).<br />

This is important if breed data are<br />

<strong>to</strong> be interpreted.<br />

Sex<br />

Age<br />

Weight<br />

Reproductive status<br />

Name of veterinarian<br />

Rabies vaccination date<br />

Rabies tag number<br />

License number<br />

Microchip number<br />

Degree of confinement . . . . . . . . . Identifying different forms of<br />

at time of <strong>bite</strong><br />

confinement (eg, chaining,<br />

tethering, electronic fence) is<br />

important if risk associated with<br />

these practices is <strong>to</strong> be assessed.<br />

Prior incidents<br />

Obedience training<br />

Circumstances of the <strong>bite</strong><br />

Victim account<br />

Owner’s account<br />

Witness account<br />

(contact information)<br />

Number of <strong>dog</strong>s involved . . . . . . . . Attacks by multiple <strong>dog</strong>s may<br />

account for 20 <strong>to</strong> 30% of incidents.<br />

Forms for these animals could be<br />

given case numbers with a special<br />

designation (eg, 123A, 123B).<br />

Injury information<br />

Location of injury<br />

Nature of injury<br />

Severity of injury<br />

Animal disposition<br />

Quarantine location<br />

Date of quarantine<br />

Date <strong>to</strong> be released<br />

Quarantined by<br />

Euthanatized<br />

Continued on next page.<br />

1748 Vet Med Today: Canine Aggression Task Force JAVMA, Vol 218, No. 11, June 1, 2001

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