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In New York State, health care providers are required to report any potential human rabies exposures to the local Health Department.  This includes all animals bites and scratches from both wild and domestic animals, regardless of rabies vaccination status.  Once the report is filed, we will investigate the circumstances of the incident to determine whether or not post-exposure rabies treatment will be necessary.

This webform is intended for use by health care providers when submitting reports of a potential exposure. There is a fillable pdf at the bottom of this page, that can be filled out and faxed to (716) 701- 3737.

Blocks marked with an asterisk (*) are required.


Name of the person or organization reporting the animal bite / rabies exposure.
Date when the animal bite / rabies exposure occurred
Name of the person bitten / exposed
Age of the person bitten / exposed
If the person bitten or exposed is a minor, enter the name of the parent or guardian to be contacted
Address of the person bitten / exposed.
Telephone number of the person bitten / exposed (or parent / guardian)
Where on the body was the person bitten / exposed
Describe any medical treatment administered to the person exposed / bitten
Name of the family physician that may be contacted regarding the animal bite / exposure
Telephone number the family physician may be contacted at
Species of the animal that bit / exposed the person above
Breed of the animal
Describe any identifying features of the animal that bit / exposed the person above
Is the animal owned or a wild animal / stray?
Name of the animal's owner
Address of the animal's owner (if domestic)
Telephone number of the animal's owner
Rabies Vaccination Status
Did the animal have a current rabies vaccination at the time of the bite / exposure?
Place of most recent rabies vaccination
Date of most recent rabies vaccination
Describe the circumstances of the bite / exposure, or any other information that may be helpful during investigation of the incident.