Environmental Health

Report an Animal Bite/Bat Exposure

Note: If the owner of the animal lives in another county in Iowa, visit the Iowa Health & Human Services website for statewide points of contact.

Animal Bite/Bat Exposure Record

Form completed by
Phone # for person completing form
Date bite/exposure occurred
Date treated

Medical facility treated

Person Bitten/Exposed to Bat Information

First name
Last name

DOB
Sex

If minor, parent name
Phone (day)
Phone (evening)
Email
Address
City
State
Zip

What location on your body were you bitten?
Description of Injury
Treatment provided
Were rabies vaccinations given to person bitten?

Animal Information

Address bite/bat exposure occurred
City
State
Zip

Animal type
Breed
Color
Animal name
Age
Owner name
Owner sex
Owner address (If there is no owner, use the address of the bite/bat exposure)
City
State
Zip

Owner phone (day)
Owner phone (evening)

Owner email
Veterinarian name
Vet phone #
Rabies tag #
Expiration date
Quarantined
Where
Circumstances of bite and other related information

Environmental Health

Animal Bites Board of Health Health Fee Schedule Onsite Wastewater Treatment Private Water Supply Public Health Radon Registered Onsite Wastewater Installers Soil Analysis Time of Transfer FAQ Department Home

Jackson County Courthouse 201 W. Platt St.
Maquoketa, IA 52060
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Department Hours May Vary

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