THE SCIENTIFIC RACCOON JOURNAL

A New Dog - Bringing Raccoons in from the Cold in Urban Areas

Claims Against Raccoons - Injuries to Cats & Dogs and Other Domestic Animals

Your Name and Contact Information Last Name: First Name:

Street Number: Street Name: Suite/Unit Number:

City: Canadian Province: Postal Code:

Home Phone: Cell Phone: Email Address:

Address of Cat & Dog and Other Domestic Animal Injuries if Different Than Above Street Number: Street Name: Suite: City:

Province: Postal Code: Contact Phone Number (if different than above):

Estimated Monetary Amount of Injuries to Cat(s) & Dog(s) and Other Domestic Animals Number of Domestic Animals Involved: .......

Estimated Monetary Amount of Injuries to Cat(s):.............

Estimated Monetary Amount of Injuries to Dog(s):............

Estimated Monetary Injuries to Other Animal(s):...............


TOTAL AMOUNT OF CLAIM:.........................................

Description of the Injuries to Cat(s) & Dog(s) and Other Domestic Animals Cat Injuries:

Dog Injuries:

Other Animal Injuries: