Animal Control Incident Report
Use this form to report animal control incidents, complaints, or enforcement actions
Incident Information
Date Reporting
*
-
Month
-
Day
Year
Date
Time Reporting (AM/PM)
*
Hour Minutes
AM
PM
AM/PM Option
Date Incident Occurred
*
-
Month
-
Day
Year
Date
Time Incident Occurred
*
Hour Minutes
AM
PM
AM/PM Option
Location Type
*
Residential
Commercial
Public
Rural
Other
Address Incident Occurred
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Incident
*
Stray Animal
Bite / Attack
Animal Cruelty / Neglect
Dead Animal
Injured / Sick Animal
Nuisance Complaint
Animal Confined in Vehicle
Other
Reporting Party
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
Relationship
*
Witness
Victim
Peporting Party
Animal Owner Information (If Applicable)
Owner Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
-
Month
-
Day
Year
Date
Animal(s) Involved
If more than one animal is involved, please list them in the narrative section.
Animal Name
Species
*
Dog
Cat
Other
Breed
Color
Gender
*
male
Female
Unknown
Age
Coller / Tag
Yes
No
Microchip
Yes
No
Narrative Description of Incident
Narrative Description: Describe the incident, observations, actions taken, witness statements, behavior, injuries, etc.
Submit
Should be Empty: