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2. 
3. Police Department | Animal Services Division
   1950 Stevenson Boulevard
   P.O. Box 5006
   Fremont, CA 94537-5006
   Phone: 510-790-6640
   Fax: 510-790-6632
   Website

5. If a bite is in progress, call 911 or Animal Services at 510-790-6640.
   
   If you have been bitten by a wild or domestic animal, seek medical attention immediately.

7. Your Name*
8. Name of Person Bitten if Different
9. Your Relationship to Person Bitten
11. Email*
12. Phone*
14. Address*
15. Zip Code*
19. Address of Incident
20. Date of Bite
    Date of Bite

    Date of Bite
22. What kind of animal bit you?*
23. Where on your body did you get bitten?*
25. Description of Animal
27. Do you know the animal's owner?

    1. Yes
    2. No
28. If yes, animal owner's name, address and phone number
32. Did victim get medical attention?*

    1. Yes
    2. No
33. If yes, specify hospital, doctor, and doctor's phone number
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37. 1. Receive an email copy of this form.
38. Email address

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39. Submit

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