DIHAC

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Dog Bite/Attack

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Were you bitten or attacked by a dog?

Did the bite or attack occur within the last 3 years?

Did you suffer an injury as a result of being bitten or attacked by a dog?

Did you require medical treatment?

Did you undergo surgery or have any doctor recommend surgery for the injuries suffered as a result of the dog bite or attack?

Do you have a scar as a result of the dog bite or attack?

Has the owner of the dog been identified?

Does the dog owner have a homeowner’s insurance policy?

Are you related to the dog owner?

At the time of the bite or attack, did you and the dog owner live in the same residence?

Did you report the dog bite or attack to the police or animal control?

Was the dog owner:

As a result of the dog bite or attack did you miss time from your job?

Did you incur medical expenses as a result of the dog bite or attack?

What best describes your injuries today?

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