Today's Date * Please enter today's date (the date you are making this report). Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Date Pet was Lost * Please enter the date your pet went missing. Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Pets Name * Please enter your pets name Type of pet * Please select what type of pet you lost Dog Cat Other What Species? Please enter the species of your lost pet (ie: Cow, Sheep, Lizard, Snake, etc.) Sex of Pet * Please enter the gender of your pet. Male Female Spayed / Neutered? * Please select if your pet has been altered (spayed or neutered). Yes No Breed * Please enter the breed(s) of your pet. If your pet is a mix breed, please list the most prominent breed first. Approximate Age * Please enter the age, or approximate age of your pet. Color * Please enter your pet's coat colors. When entering, please enter the most prominent color first. Location Lost * Please enter the location your lost your pet, be as specific as possible and be sure to include the town your pet went missing from. Your Name * Please enter your First and Last Name Your address * Please enter your address. Be sure to include your address, city and state Your Phone number * Please enter your phone number, you may enter more then (1) number. Please separate each number with a comma. Your email address Please enter your email address Are you the owner of the pet? * If you select no, to any of the following you questions, you must enter owner information below. Yes No, I am a caretaker for the pet No, I am a friend of the pet owner or caretaker No, Other Owners Name * Please enter the name of the owner Owners Address * Please enter the Owner's Address. Be sure to include their address, city and state Owner's Phone * Please enter the owner's phone number, you may enter more then (1) phone number. Owners email address Describe your Pet * Are there any distinguishing marks or special characteristics that would set your pet apart from others of the same breed? Was your pet wearing a collar? * Yes No Unknown Does your pet have a microchip? * Yes No Unknown Microchip Number Please upload an image of your pet Please attach a picture if available. Providing a clear picture will greatly increase the chances that you will be contacted if your pet shows up at the shelter. If you do not have one with you but wish to bring one back we would be more than happy to attach it to your report.Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. Do you wish to enter additional information about your pet? * If you select yes, all fields will be required. Yes No Ears * Erect Semi-erect Drooping / folded Cropped Unknown Coat * Short Medium Long Unknown Coat Texture * Wiry Curly / Wavy Smooth Unknown Tail * Cropped Long Short Unknown Recently Groomed? * Yes No Unknown Release of Information * In the event your pet is found by a good Samaritan, and turned into another Animal Welfare Organization (Veterinary Hospital, Animal Control Department, Animal Shelter, etc.), do you consent for us to provide your information (name, address, email, and phone number) to that facility? Yes, you may release my contact information to another Animal Welfare Organization No, you may not release my contact information No, Confirmation * I understand that by select 'NO' above that my contact information to be shared. I further understand that a single notification attempt will be made to each phone number or email address provided in this web submission form by the members of Hadley Animal Control and or Hadley Police Department. I agree to the above statement and understand it Leave this field blank
