Report an Illness or Health IncidentKDHE, KS 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Incident Information' section. Enter the county where the incident occurred, the date and time of the incident, and provide a detailed address including city, state, and zip code.
3. In the 'Reporting Facility or Individual Information' section, input your current time and date along with your contact information. Specify your role (e.g., Animal Control, Physician) and include your facility name if applicable.
4. Complete the 'Human Victim Information' section for any individuals affected. Include their name, weight, sex, age, guardian details (if minor), and contact information.
5. Fill out the 'Animal Victim Information' section by indicating the number of animal victims and providing details such as size/color, breed, type of animal, owner’s name, and health status.
6. Lastly, complete the 'Offending Animal Information' section with similar details about any offending animals involved in the incident.

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