Victim feedback form

Dog Bite victims: Please complete the form below

  • Age of victim
  • Date of incident
    Was the dog known to be aggressive prior to the attack on the victim?
    How familiar was the victim with the dog?
    Did the victim and dog live in the same household?
    Location on body where victim was bitten
    How many stitches did the victim require?
    Was victim hospitalized?
    Consent to having this info forwarded to an attorney?