Bat Exposure Questionnaire

Name of individual submitting this form

First NameLast Name

Phone number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Did the exposure occur at the address listed above?

Address where the exposure occurred

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Give a brief summary of the exposure to the bat (Ex. found the bat after waking up, bit by bat, pet caught bat, etc.)

Who may have had contact with the bat or been exposed to it?

How many people were exposed?

Name of person who was exposed

First NameLast Name

Date of birth

Date

Name of person who was exposed (2)

First NameLast Name

Date of birth (2)

Date

Name of person who was exposed (3)

First NameLast Name

Date of birth (3)

Date

Name of person who was exposed (4)

First NameLast Name

Date of birth (4)

Date

Name of person who was exposed (5)

First NameLast Name

Date of birth (5)

Date

Type the full name (last name, first name) and date of birth (mm/dd/year) for all individuals who were exposed to the bat.

How many pets were exposed to the bat?

Pet name

What type of animal is your pet?

Other

Are they up to date (current) on their rabies vaccine?

Pet name (2)

What type of animal is your pet? (2)

Other

Are they up to date (current) on their rabies vaccine? (2)

Pet name (3)

What type of animal is your pet? (3)

Other

Are they up to date (current) on their rabies vaccine? (3)

Pet name (4)

What type of animal is your pet? (4)

Other

Are they up to date (current) on their rabies vaccine? (4)

Pet name (5)

What type of animal is your pet? (5)

Other

Are they up to date (current) on their rabies vaccine? (5)

List all pets (name), what type of animal they are (cat, dog, other) and their vaccination status (up to date/current, not up to date, but previously vaccinated, never vaccinated, unknown)

Is the bat available to be brought in for testing?

Other

Please call the health department for further guidance on how to proceed. If you or your pet(s) are injured, please seek medical care.

Monday through Friday, 8am to 5pm, please call: 406-751-8117

Outside of those hours, please contact our after-hours line: 406-756-2900

Is the bat still alive?

If the bat hasn't been captured, please see this document for instructions on how to safely capture the bat: https://flatheadcounty.gov/download_file/view/95841dc3-1b0e-477e-b6c9-84ed2d28741f/2744.

For instructions on how to euthanize the bat, please see the following document: https://flatheadcounty.gov/download_file/view/320c79ab-b41a-42eb-bfea-f99a71cd9459/2744

Please DO NOT bring a live bat to the Flathead City-County Health Department. Once the bat has been euthanized, please return to the previous question, "Is the bat still alive?", and change your selection to "No."

PLEASE READ THE FOLLOWING INFORMATION:

If it is a weekend, or outside of our business hours, please keep the bat refrigerated. Do NOT freeze the bat as this may make it unsuitable for testing.

If you are unable to pick a drop off time or have any questions, please reach out to one of the following contact numbers:

Monday through Friday, 8am to 5pm, please call: 406-751-8117

Outside of those hours, please contact our after-hours line: 406-756-2900

If you are filling this form out on a Friday (after 5pm), Saturday or Sunday please contact our after-hours line (406-546-2900) if you have any questions, or if there was a pet exposure*.

*All pets are recommended to recieve a rabies vaccine within 96-hours after an exposure to a suspected rabid animal or bat. Due to testing delays, we may recommend you take your pet to their veterinarian to receive a booster if results will not arrive in the 96-hour timeframe.

Pick a date and time to drop the bat off at the health department

Flathead City-County Health Department is located at:

1035 1st Avenue West, Kalispell, MT 59901

NOTICE:

A staff member will reach out to you if we need to gather more information. We will provide more information to you on when results can be expected once we recieve the bat.