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Report an Animal Bite or Bat Exposure

Please complete this form if you or your child have been bitten by an animal or exposed to a bat or other animal that could have rabies.

Our staff will contact you within one business day to ask additional questions and determine if the animal needs testing and/or if the exposed person needs medical treatment.
If you are completing this form after hours or on the weekend, please seek medical care if an animal has bitten someone.
If you find a bat in your house, please don't let it go until you speak with a member of our staff. We provide case-by-case consultation regarding the need for post-exposure prophylaxis (rabies vaccine). Please visit our website for tips on capturing a bat. Please do not bring live bats to the Health Department. Fill out this form and wait for a staff member to contact you with next steps.
Please only use this form to report an animal bite or bat exposure for someone who lives in Washtenaw County, or if the incident occurred in Washtenaw County, Michigan.
If you have additional questions or concerns, call the Washtenaw County Health Department at 734-544-6700.
This form is secure and HIPAA-compliant. Please provide as much detail as possible.

Today's date (MM/DD/YYYY): *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

First and last name of person who was bitten or exposed:
(if additional people in the same household were exposed, please add them at the end of this form) *This question is required.

Date of birth of person who was bitten or exposed (MM/DD/YYYY): *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Is the person who was bitten or exposed under age 18? *This question is required.

First and last name of parent or legal guardian: *This question is required.

Contact information for parent or legal guardian: *This question is required.

Cell Phone
Home Phone
Email

Contact information for person who was bitten or exposed: *This question is required.

Cell Phone
Home Phone
Email

Home address of person who was bitten or exposed: *This question is required.

Street address
City
State
Zip code

Date of bite or exposure (MM/DD/YYYY): *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Time of day of bite or exposure (include AM or PM): *This question is required.

Location where bite or exposure occurred: *This question is required.

Street address
City
Zip code

How was the person exposed to the animal? *This question is required.

Please enter an 'other' value for this selection.

Did the bite break the skin? *This question is required.

Location on body where the person was bitten: *This question is required.

Animal Type: *This question is required.

Is the animal a feral or wild animal? *This question is required.

Is the animal a pet? *This question is required.

Is the animal your pet or does it live with you? *This question is required.

First and last name of pet owner *This question is required.

Contact information for pet owner *This question is required.

Cell phone
Home phone
Email
Home street address
City
Zip code

What is the current location of the animal? *This question is required.

Has the person who was bitten or exposed contacted or visited a doctor, hospital, ER, urgent care, or other healthcare provider or facility for this incident? *This question is required.

Please provide the following information about the healthcare provider and/or facility: *This question is required.

Healthcare provider name
Healthcare facility name
Address
Phone

Was anyone else bitten or exposed to the animal? *This question is required.

Who else was bitten or exposed?

Space Cell	Name (first and last)	Phone
Person 1	Person 1: Name (first and last)	Person 1: Phone
Person 2	Person 2: Name (first and last)	Person 2: Phone
Person 3	Person 3: Name (first and last)	Person 3: Phone
Person 4	Person 4: Name (first and last)	Person 4: Phone

Please describe the bite or exposure incident: *This question is required.

Please share any other information that could be helpful for the Washtenaw County Health Department to know at this time.