Date of incident
Date of incident
Time of incident
Time of incident
clearly, seconds aren't required
(near gate, center, south area, etc.)
Name of Reporting Party *
Name of Reporting Party
Phone
Phone
Name of your dog
Name of your dog
last name not necessary
Name of other dog
Name of other dog
If known
Name of other dog's companion
Name of other dog's companion
(indicate if none)
Actions taken as a result of injuries *
Include witnesses, if any