Columbia County Humane Society
Lost Animal Report

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Your Information:

Your Name:

Address:

City: State: Zipcode:

Home Phone: Cell Phone: Work Phone:

Email address:

Date Animal was lost: 01/01/07

Animal Information:

Type of animal you are looking for: dog, cat, bird, etc...

Breed(s): Breeds if mixed.

Color(s):

Sex of the Animal:  

Is the Animal Microchipped? No Yes

Was the animal wearing a collar? No Yes

If yes, Color, Type, and/or Design of collar:

Tags worn on collar: Rabies, Dog License, Name...

This animal is an: Indoor Animal Outdoor Animal Both

Age of the Animal: Name of the Animal:

Where the animal was last seen. Please include City and approximate Street(s)

For Cats

Declawed: Front Back Front and Back Not Declawed

Type: Domestic Short Haired Domestic Medium Haired Domestic Long Haired

Please provide extra information that will help us in identifying your pet.

Examples: Any unique personality traits that a typical animal would not have.
Unique marking or scaring, trick(s), medications needed or health concerns, or anything else that you feel would help.
These traits or conditions can help us identify your animal!

CCHS HAS THE RIGHT TO ACCEPT OR DENY THIS REPORT.

I hereby state the information provided is true to the best of my knowledge.

Agree Disagree

Note: You must have an email service running on this computer to use this form.