Leichhardt Rangers DOG ATTACK INVESTIGATION

DOG ATTACK

• Document No.

DOG ATTACK INVESTIGATION

• INVESTIGATION TITLE

• DATE RECEIVED

  Date

• INVESTIGATION DATE

  Date

• REQUEST NUMBER

• INVESTIGATING OFFICER

  Select Ronnie Busuttil David Chariton Bang Le Peter Lee Peter Parker Preet Singh

  • Ronnie Busuttil
  • David Chariton
  • Bang Le
  • Peter Lee
  • Peter Parker
  • Preet Singh

VICTIM INFORMATION

• Victim Details

Person

• Name

• Contact Information

• Age

• Seriousness of attack

  Serious

  Minor

  Cause fear

• Nature of Injury (select multiple if needed)

  Select bruising abrasion puncture cut/laceration crush injury fracture

  • bruising
  • abrasion
  • puncture
  • cut/laceration
  • crush injury
  • fracture

• Body part affected

  Select head/face neck arms/hands front torso back torso buttocks legs/feet

  • head/face
  • neck
  • arms/hands
  • front torso
  • back torso
  • buttocks
  • legs/feet

• Outcome/Treatment

  Select None First Aid GP consult Accident & Emergeny Ambulance Fatality

  • None
  • First Aid
  • GP consult
  • Accident & Emergeny
  • Ambulance
  • Fatality

• Summery of the Incident

• Injury Photographs

  Media

INJURED ANIMAL INFORMATION

• Number of injured animals

• Animal Details

Animal

• Animal Type

  Select dog cat poultry sheep cattle other

  • dog
  • cat
  • poultry
  • sheep
  • cattle
  • other

• Breed

• Owners Name

• Contact Information

• Seriousness of attack

  Serious

  Minor

  Cause fear

• Nature of Injury (select multiple if needed)

  Select bruising abrasion puncture cut/laceration crush injury fracture

  • bruising
  • abrasion
  • puncture
  • cut/laceration
  • crush injury
  • fracture

• Body part affected

  Select head neck back abdomen fore-legs hind-legs tail

  • head
  • neck
  • back
  • abdomen
  • fore-legs
  • hind-legs
  • tail

• Outcome/Treatment

  none

  Vet consult

  Vet surgery

  Death/Euthanasia

• Injury Photographs

  Media
Description of the Attacking Dog

• Dog size

  small

  medium

  large

• Collar/Distinguishing Marks

• Colour

• Gender

  Male

  Female

  unsure

• Breed if Known

• Owners Address if known

LOCATION OF ATTACK

• Address of incident
  Address

• Place of occurrence

  Select Owner/keepers property Public place School Farm Friends/relatives property In/from a vehicle

  • Owner/keepers property
  • Public place
  • School
  • Farm
  • Friends/relatives property
  • In/from a vehicle

• Photo of incident area (include holes, broken fences etc.)

  Media

INCIDENT INFORMATION

• Was the attacking dog on a leash?

  Yes

  No

  unsure

• Was the attacking dog provoked?

  Yes

  No

  unsure

• Summary of Incident

• Is a statement attached?

  Yes

  No

  N/A

WITNESSES

• Witness information

Witness

• Name

• Address

• Phone number/s

• Description of attacking dog/s

• Summary of incident

• Notice Issued

  Nuisance

  Menacing

  Dangerous

• Date of Notice

  Date

• Order issued

  Date

ATTACKING DOG INFORMATION

Attacking dog

• Owner Name

• Address

• Phone Number/s

• Dogs Name

• Registration number

• Is the animal registered?

  Yes

  No

  unsure

• Breed

• Gender

  Male

  Female

  unsure

• Colour

• Desexed

  Yes

  No

  unsure

• Photo of attacking dog

  Media