Incident Report

If your dog is involved in a fight or other such incident in the park, we ask that you use this form to file a report (you must be logged into the site to access this attachment). This helps us determine what circumstances are most likely to lead to fights. We can then establish groundrules that avoid these situations and lead to a more peaceful environment. It also helps us identify dogs that exhibit problem behavior and take steps appropriate to the circumstances.

You may cut and paste the following into a WORD document or download the form at the bottom of this page using Adobe if you are logged in to our site. If you don’t have Adobe, you may click here to Download it.

Seger Dog Park Owners Association
Incident Report Form

Date of incident: ___________________________

Your name and contact information:
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________

Dogs involved: ____________________________________________

     Names ______________________

     Breeds/ages/sexes ______________________

     Spayed or neutered? ______________________

     Are vaccinations current? ______________________

     Names of veterinarians:
     ____________________________________________

     ____________________________________________

Owners’ names and contact information:

      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________

      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________

Did the owners exchange contact information?

     [ ] Yes     [ ] No

Witnesses’ names and contact information:

      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________
      ________________________________________________________

Incident report:

Was the incident triggered by

[ ] Toy     [ ] Food     [ ] Mounting or other dominant behavior    
[ ] Other  ______________________________________

Description of incident

Were any people injured?

Were any dogs injured?

Please submit this form by giving it to an SPDOA officer, or mailing it to SPDOA; P.O. Box 1405; Philadelphia, PA 19105.

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IncidentReportForm.pdf14.39 KB