If you have any questions or comments about filling out this form or submitting a specimen, please call 501-280-4136.
In Arkansas, bats and skunks are the main sources of rabies. Other mammals, such as raccoons, may be higher risk in other states. Only mammals, including dogs and cats, can carry and transmit rabies; birds and reptiles cannot.
The Arkansas Public Health Lab is the only laboratory in the state that is able to confirm rabies infection in animals by testing for the virus which will be present in the brain at any stage of the disease during which the virus can be transmitted. Currently, there are no reliable, standardized ante-mortem (live animal) tests that can be used to confirm whether an animal is infected with rabies. Fresh brain tissue from three sections (brainstem, cerebellum, and hippocampus) are required for this test. Brain tissue must be maintained fresh and chilled or frozen in good condition in order to receive a valid test result. Tissues should not be submitted in formalin or alcohol for this test.
If a domestic or pet animal bites a human or another animal, and the animal is not ill and there is no other reason than the biting incident to suspect rabies, the bite animal can be confined and observed for 10 days. If symptoms develop during the holding period, the animal should be euthanized and the head removed to be sent to the laboratory for testing. If no symptoms develop during the holding period, the exposed person is considered not at risk for rabies.
A wild or stray animal that bites a human or another animal must always be euthanized and sent to the laboratory for testing. The head should be removed, refrigerated immediately, and submitted to the laboratory as soon as possible. The rest of the body should be incinerated or buried deep enough to prevent scavenging.
The entire body of small animals (smaller than the palm of a hand), such as bats, should be sent to the laboratory. Unless circumstances surrounding the exposure suggest rabies infection, caged rodents such as hamsters, mice, etc., should not be submitted for testing.
If there was a human or pet exposure, potentially decomposed or destroyed brains can still be submitted to the laboratory; however, these samples may not be testable. If the sample is deemed unsatisfactory, ADH will determine risk and advise on the need for post-exposure prophylaxis.
If a domestic or pet animal is exposed to a suspected rabid animal (i.e. a dog killed the skunk being submitted for testing), the pet should be vaccinated for rabies immediately while awaiting results of testing, at which time further instructions will be provided on how the exposed animal is to be handled if the tested animal is positive for rabies.
Rabies buckets and shipping boxes can be obtained from the nearest Arkansas Department of Health Local Health Unit where a courier will pick up and transport the specimen to the lab in Little Rock. Specimens received that are decomposed, damaged, or without completed paperwork may be rejected if unable to test. Specimens collected after courier pick-up, weekends, or holidays must be kept cool until next courier pick-up in order to assure freshness of the sample.
For submitting an animal encounter you can click on this link: Animal Encounter Intake Form (arkansas.gov)
Type of submitter:
* must provide value
Veterinarian Animal Control Officer Police Officer Local Health Unit Owner of the animal being submitted or individual who found the animal Other
Investigation/Animal Report ID number:
Investigation/Animal Report upload:
Contact Name:
* must provide value
Address:
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City:
* must provide value
State
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Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
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County
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Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
County
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Anderson Andrews Angelina Aransas Archer Armstrong Atascosa Austin Bailey Bandera Bastrop Baylor Bee Bell Bexar Blanco Borden Bosque Bowie Brazoria Brazos Brewster Briscoe Brooks Brown Burleson Burnet Caldwell Calhoun Callahan Cameron Camp Carson Cass Castro Chambers Cherokee Childress Clay Cochran Coke Coleman Collin Collingsworth Colorado Comal Comanche Concho Cooke Coryell Cottle Crane Crockett Crosby Culberson Dallam Dallas Dawson Deaf Smith Delta Denton DeWitt Dickens Dimmit Donley Duval Eastland Ector Edwards El Paso Ellis Erath Falls Fannin Fayette Fisher Floyd Foard Fort Bend Franklin Freestone Frio Gaines Galveston Garza Gillespie Glasscock Goliad Gonzales Gray Grayson Gregg Grimes Guadalupe Hale Hall Hamilton Hansford Hardeman Hardin Harris Harrison Hartley Haskell Hays Hemphill Henderson Hidalgo Hill Hockley Hood Hopkins Houston Howard Hudspeth Hunt Hutchinson Irion Jack Jackson Jasper Jeff Davis Jefferson Jim Hogg Jim Wells Johnson Jones Karnes Kaufman Kendall Kenedy Kent Kerr Kimble King Kinney Kleberg Knox La Salle Lamar Lamb Lampasas Lavaca Lee Leon Liberty Limestone Lipscomb Live Oak Llano Loving Lubbock Lynn Madison Marion Martin Mason Matagorda Maverick McCulloch McLennan McMullen Medina Menard Midland Milam Mills Mitchell Montague Montgomery Moore Morris Motley Nacogdoches Navarro Newton Nolan Nueces Ochiltree Oldham Orange Palo Pinto Panola Parker Parmer Pecos Polk Potter Presidio Rains Randall Reagan Real Red River Reeves Refugio Roberts Robertson Rockwall Runnels Rusk Sabine San Augustine San Jacinto San Patricio San Saba Schleicher Scurry Shackelford Shelby Sherman Smith Somervell Starr Stephens Sterling Stonewall Sutton Swisher Tarrant Taylor Terrell Terry Throckmorton Titus Tom Green Travis Trinity Tyler Upshur Upton Uvalde Val Verde Van Zandt Victoria Walker Waller Ward Washington Webb Wharton Wheeler Wichita Wilbarger Willacy Williamson Wilson Winkler Wise Wood Yoakum Young Zapata Zavala
Texas County
County
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Adair Andrew Atchison Audrain Barry Barton Bates Benton Bollinger Boone Buchanan Butler Caldwell Callaway Camden Cape Girardeau Carroll Carter Cass Cedar Chariton Christian Clark Clay Clinton Cole Cooper Crawford Dade Dallas Daviess DeKalb Dent Douglas Dunklin Franklin Gasconade Gentry Greene Grundy Harrison Henry Hickory Holt Howard Howell Iron Jackson Jasper Jefferson Johnson Knox Laclede Lafayette Lawrence Lewis Lincoln Linn Livingston Macon Madison Maries Marion McDonald Mercer Miller Mississippi Moniteau Monroe Montgomery Morgan New Madrid Newton Nodaway Oregon Osage Ozark Pemiscot Perry Pettis Phelps Pike Platte Polk Pulaski Putnam Ralls Randolph Ray Reynolds Ripley Saline Schuyler Scotland Scott Shannon Shelby St. Charles St. Clair St. Francois St. Louis St. Louis City Ste. Genevieve Stoddard Stone Sullivan Taney Texas Vernon Warren Washington Wayne Webster Worth Wright
Missouri County
County
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Adair Alfalfa Atoka Beaver Beckham Blaine Bryan Caddo Canadian Carter Cherokee Choctaw Cimarron Cleveland Coal Comanche Cotton Craig Creek Custer Delaware Dewey Ellis Garfield Garvin Grady Grant Greer Harmon Harper Haskell Hughes Jackson Jefferson Johnston Kay Kingfisher Kiowa Latimer Le Flore Lincoln Logan Love Major Marshall Mayes McClain McCurtain McIntosh Murray Muskogee Noble Nowata Okfuskee Oklahoma Okmulgee Osage Ottawa Pawnee Payne Pittsburg Pontotoc Pottawatomie Pushmataha Roger Mills Rogers Seminole Sequoyah Stephens Texas Tillman Tulsa Wagoner Washington Washita Woods Woodward Perry Pettis Phelps Pike Platte Polk Pulaski Putnam Ralls Randolph Ray Reynolds Ripley Saline Schuyler Scotland Scott Shannon Shelby St. Charles St. Clair St. Francois St. Louis St. Louis City Ste. Genevieve Stoddard Stone Sullivan Taney Texas Vernon Warren Washington Wayne Webster Worth Wright
Oklahoma County
Other County
Phone Number:
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This email is for used solely for sending confirmation upon survey completion
What species of animal is being submitted for testing?
* must provide value
Bat Cat Cow Dog Ferret Fox Horse Raccoon Skunk Other
Gray Red Unknown
Striped Spotted Unknown
The submitted animal was:
* must provide value
Pet/Owned
Stray/Un-owned
Wild
Unknown
Pet/Owned
Stray/Un-owned
Wild
Unknown
years
Juvenile Adult Unknown
Date animal died:
* must provide value
Today M-D-Y (M-D-Y)
How did the animal die?
* must provide value
Found dead Natural Causes Killed Unsure
How was the animal killed?
* must provide value
Euthanized
Shot by someone
Other
Euthanized
Shot by someone
Other
Who performed the euthanasia?
Veterinary Clinic
Animal Control
Veterinary Clinic
Animal Control
Please explain how the animal died.
Shooting animals in the head may result in an unsatisfactory sample for testing, depending on the bullet caliber, pathway through the animal, and rate of decomposition.
Was the animal symptomatic?
* must provide value
Yes
No
Unknown
Which symptoms did the animal exhibit? Check all that apply.
* must provide value
Was the submitted animal being held for rabies observation at the time of death?
* must provide value
Yes No Unknown
Date Rabies Observation/Quarantine began:
Today M-D-Y
View equation What is the rabies vaccination status of the animal being tested?
* must provide value
Current Not Current Unvaccinated Vaccination with unknown last date Unknown
Today M-D-Y
Was the rabies vaccination administered by a licensed veterinarian?
* must provide value
Yes No Unsure/Unknown
Name of animal being submitted:
Are the submitter and owner the same person?
* must provide value
Yes No
Owner's Name:
* must provide value
Owner's City:
* must provide value
State
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
* must provide value
County
* must provide value
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
County
* must provide value
Owner Contact Number
* must provide value
Is the person who found the animal also the submitter?
Yes
No
Name of the person who found the animal:
Phone Number of the person who found the animal:
Physical address where animal was found:
City where animal was found:
* must provide value
Zip code where animal was found
State where animal was found:
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
County
* must provide value
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
County
* must provide value
Were other humans or animals exposed to the suspected rabid animal?
* must provide value
Briefly describe the circumstances of the exposures
How many people were exposed?
* must provide value
1 2 3 More than 3 Unsure
If more than 3 people were exposed, list the people who were bitten first. Non-bite and other exposures can be added to the notes field below the 3rd person.
Address
* must provide value
State
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
County
* must provide value
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
County in Arkansas
County
* must provide value
Out of State County
Phone Number:
* must provide value
What type of non-bite exposure?
Specify non-bite exposure:
Has the exposed person received post exposure rabies treatment?
* must provide value
Yes No Unknown
Name of the hospital or clinic where treatment was given:
* must provide value
Date post-exposure treatment began
Today M-D-Y
Address
* must provide value
State
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
County
* must provide value
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
County in Arkansas
County
* must provide value
Out of State County
Phone Number
* must provide value
What type of non-bite exposure.
Specify non-bite exposure:
Has the exposed person received post exposure rabies treatment?:
* must provide value
Yes No Unknown
Name of the hospital or clinic where treatment was given:
* must provide value
Date Post Exposure Treatment Began
Today M-D-Y
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
County in Arkansas
Out of State County
What type of non-bite exposure.
Specify non-bite exposure:
Has the exposed person received post exposure rabies treatment?:
* must provide value
Yes No Unknown
Name of the hospital or clinic where treatment was given:
Date Post Exposure Treatment Began
Today M-D-Y
Additional Human Exposure Notes
Were any domestic animals exposed to the tested animal?
* must provide value
Yes No Unsure
How many animals were exposed?
1 2 3 More than 3 Unsure
Species of animal exposed
Dog Cat Ferret Horse Cow Other
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
Species of animal exposed
Dog Cat Ferret Horse Cow Other
Is the owner contact information the same as the previous animal?
Yes
No
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
Species of animal exposed
Dog Cat Ferret Horse Cow Other
Is the owner contact information the same as the previous animal?
Yes
No
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Arkansas Ashley Baxter Benton Boone Bradley Calhoun Carroll Chicot Clark Clay Cleburne Cleveland Columbia Conway Craighead Crawford Crittenden Cross Dallas Desha Drew Faulkner Franklin Fulton Garland Grant Greene Hempstead Hot Spring Howard Independence Izard Jackson Jefferson Johnson Lafayette Lawrence Lee Lincoln Little River Logan Lonoke Madison Marion Miller Mississippi Monroe Montgomery Nevada Newton Ouachita Perry Phillips Pike Poinsett Polk Pope Prairie Pulaski Randolph St. Francis Saline Scott Searcy Sebastian Sevier Sharp Stone Union Van Buren Washington White Woodruff Yell
Your sample's ID# will be generated by clicking "Submit" or by clicking "Save & Return Later"
Submitter Type: ______ Investigation/Animal Report ID #: ______ Agency or Clinic Name: ______
Contact Name: ______ Street Address: ______ City, State, ZIP: ______ , ______ , ______ County: ______ Phone: ______ Email: ______
Contact Name: ______ Street Address: ______ City, State, ZIP: ______ , ______ , ______ County: ______ Phone: ______ Email: ______
Contact Name: ______ Street Address: ______ City, State, ZIP: ______ , ______ , ______ County: ______ Phone: ______ Email: ______
Contact Name: ______ Street Address: ______ City, State, ZIP: ______ , ______ , ______ County: ______ Phone: ______ Email: ______
Contact Name: ______ Street Address: ______ City, State, ZIP: ______ , ______ , ______ County: ______ Phone: ______ Email: ______
Species Submitted: ______ , ______ Age: ______
Species Submitted: ______ , ______ Estimated Age: ______
Species Submitted: ______ , ______ Age: ______
Species Submitted: ______ , ______ Estimated Age: ______
Species Submitted: ______ - ______ Age: ______
Species Submitted: ______ - ______ Estimated Age: ______
Species Submitted: ______ Age: ______
Species Submitted: ______ Estimated Age: ______
Symptoms Exhibited by Submitted Animal: ______
No Symptoms were were observed in the submitted animal.
Symptoms Exhibited by Submitted Animal: ______ --______
After clicking submit, please download and print the pdf summary. Include it in the bucket with the sample.
Submit
Save & Return Later
