Get Va Cshd Animal Exposure Report Form 2012-2025

Completing the VA CSHD Animal Exposure Report Form accurately is essential for documenting animal exposure incidents. This guide provides systematic instructions for filling out the form online, ensuring that users can navigate each section with ease and confidence.

Follow the steps to fill out the VA CSHD Animal Exposure Report Form online.

1. Press the ‘Get Form’ button to acquire the form and open it in the online editor.
2. Enter the confinement date, date of the bite, and the date of the report in the designated fields.
3. Fill in the identification number and release date if applicable.
4. Provide information about the person reporting the incident, including their name and the name of the person who took the report.
5. Input the owner's information, including their last name, first name, middle name, home phone, work phone, and address.
6. Indicate the confinement location and type of animal involved, selecting from the options provided (dog, cat, or other), and fill in the animal's name.
7. Complete the description section by providing details about the animal's sex, whether it is neutered or spayed, size, age, color, and breed.
8. Specify whether the animal has a rabies vaccination certificate and provide the relevant details, including the state of vaccination, expiration date, and vaccination number.
9. Identify the veterinary clinic involved and the verifier's name, along with the date verified.
10. Document the information of the person exposed, including their name, age, and whether they are a minor.
11. Specify the exposure type, indicating if it was a bite, scratch, or other, and provide details about provocation and treatment status.
12. Record the body location that was exposed, type of treatment received, and the medical facility that treated the exposed individual.
13. List the physician's name and contact number who treated the exposed person.
14. Acknowledge the confinement information and agree to the outlined terms by signing at the designated area.
15. After completing all necessary fields, save the changes, and you can download, print, or share the completed form as required.

Begin completing the VA CSHD Animal Exposure Report Form online today.