Incident Report • CampusOptics

According to IACUC procedure, animal bites are to be reported immediately to the IACUC, EH&S Office, and the appropriate PI and/or supervisor.

This form serves as a means of communication and therefore must be filled out as soon as possible after the supervisor has been notified.

Please complete this form and submit as soon as possible to ensure documentation is complete.

For your reference, the appropriate procedure for animal bites follows:

Control Bleeding

Cleanse Wound

Bandage

Report Bite

For all bites that break the skin, procure medical follow-up

*It is recommended that student workers be referred immediately to the Student Health Center for assessment.

**Staff/Faculty should go to a panel physician approved by Worker's Compensation first-report-accident-2020.pdf

Reporter Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Campus, Building, or Outdoor Area* Required

Additional Location Details

Exact Location

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Name

Banner ID Number

IACUC Protocol Number

W&M Department

Supervisor

Date of Incident

Time of Incident

Date & Time Supervisor Notified of Incident

If you did not notify your supervisor, please advise why you did not, and notify them immediately

Details of the incident: who/what/when/where/why

Did the bite require medical attention? If so, please provide details

The Animal: species, breed, ID # of animal (if applicable), sex, color, age, health status & current location

If the animal appeared ill, please describe

Add files to upload as supporting documentation along with your incident.