LOST/MISSING DOG REPORT FORM
DATE LOST OR MISSING
_____________________________ DATE OF REPORT ______________________________DOG’S NAME
________________________________________AGE_________________ WEIGHT________________SEX OF DOG MALE ___
______ NEUTERED MALE _________ FEMALE __________ SPAYED FEMALE ___________BREED ( List top two if a mix)
__________________________________________________________________________COLOR/S & OTHER DETAILS
________________________________________________________________________COLLAR / LEASH - DESCRIBE
_______________________________________________________________________LICENSE TAG #
___________________ RABIES TAG # __________________ NAME ID TAG _____________________MICRO CHIP
# ____________________________ TATTOO # ____________________________________________OWNER/S NAME
__________________________________________________________________________________STREET ADDRESS
_____________________________________________________________PO BOX _____________CITY/TOWN
____________________________________________ STATE_________ ZIP CODE___________________HOME PHONE #
_________________________ WORK PHONE # ____________________________________________CELL PHONE #
_________________________________________ OTHER PH #_________________________________E-MAIL ADDRESS
__________________________________________________________________________________FLIER ATTACHED TO REPORT YES
_________ NO_________ PICTURE OF DOG YES _________ NO___________EXACT LOCATION DOG LOST ____________________
____________________________________________________HOW WAS DOG LOST ?
_____________________________________________________________________________OTHER DOGS IN HOME ?
_____________________________________________________________________________HOW LONG HAVE YOU HAD DOG?_____________________________________________________________________
OTHER HELPFUL INFORMATION
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