Dead End Microchip Submission

VetChipForm.com

Request help with a microchip that has outdated
owner information.

We are a nonprofit that specializes in reuniting lost animals with their owner. We would like to help you track down the dead end microchip (or tag, or address, or owner name or phone number) associated with a found animal. (DO NOT COMPLETE THIS FOR A LOST ANIMAL!) Please include as much information as you can in the following fields. If the owner is found, the contact information below will be provided to the owner.

Please note, you do not need a JotForm account. If you are asked to sign up, that is JotForm advertising.

This animal is in my possession or I have permission from the finder to complete this form. *

Yes No

Veterinary Practice *

Name of Practice

Your Phone Number *

Area Code Phone Number

Email *

example@example.com

Please include a photo of the animal. (If you cannot upload the photo, give us a description in the comment field below and if you can, email a photo to Team@MicrochipHelp.com and include the chip number.)

Name of person or practice who has possession of animal. *

Phone number of person who currently has the animal

Area Code Phone Number

Address *

Street Address

Street Address Line 2

City State / Province

Zip Code / Postal Code Country

Microchip Number - Please note a valid microchip number can only be 9, 10, or 15 characters. Some microchips do have letters, but if the length is not 9, 10, or 15, have the chip rescanned, because the number is incorrect. *

(If this is a Rabies or ID tag case, put information in the Comments field at the end and put 000 in this field)

Breed

Gender

Male Female

Approximate Age

How long will the animal be held? (Please contact us immediately if this animal goes to another location.)

If the animal is in the US, select the state. If you are in Canada, select "Canada." *

US States

Include any additional information you may have that will help us find the owner.

Comments

PLEASE NOTE! If you successfully submit this form, you will immediately see a screen with a check mark and you will immediately get a copy of your submission.

MicrochipHelp/Microchip Hunters are a 501(c)3 under Lost Dogs of Texas, but we serve the US and Canada and have volunteers from all over the country.

(02/18/20)

FOUND ANIMAL MICROCHIP FORM