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Animal Bites Report Form

* = Required

Health Care Provider Information

 

Person Bitten


No

Guardian Information

Exposure


No

Patient

Animal Owner Information

If you don't know the animal owner's information, please type "unknown" in the fields below.

xxx-xxx-xxxx

Personal Information and Privacy

Any personal information or personal health information submitted in writing will be collected, used and disclosed by members of Regional Council and Regional staff in accordance with the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act, where applicable.

Freedom of Information

Any information you share will be used only for the intended purpose for which it was provided. If you have any questions, email our Access and Privacy Office or call 905-980-6000 ext. 3779.

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