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2. Lost Pet:
4. Species*

   1. Dog
   2. Cat
   3. Other
5. If Other, Please Type here
7. Name *
8. Breed *
9. Color *
11. Distinguishing Marks *

    (Anything that makes your animal unique. Scars, old injures, deformities etc.)

13. Age *
14. Age In: *

    1. Years
    2. Months
15. Gender *

    1. Altered Male
    2. Altered Female
    3. Unaltered Male
    4. Unaltered Female
17. Is your Pet Microchipped ?*

    1. Yes
    2. No
18. Microchip Number:

    If yes then enter microchip number if known.

19. Has This Animal bitten in the past ? *

    1. Yes
    2. No

    (Even if it was out of fear, or stress, or not the animal’s fault that is ok just gives us advice on any safety measures when handling)  

21. Owner Name First & Last *
22. Phone *
24. Address*
26. City*
27. State*
28. Zip*
30. Area Pet Went missing From *

    If different from address

32. Additional Information
34. Pictures Of Animal can be uploaded here:
36. *Before we give an animal back, owner must provide proof of ownership. Photos, vet records, or shot records etc. can be used. We do not want to give a pet back to the wrong individual if someone tries to impersonate ownership.*
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field