Lost Animal Report

Your Information:

Name * Required
First Last

Address * Required
Street City State ZIP Code

Phone * Required

Cell Phone

Email * Required

Alt Email

Pet Information:

Name * Required
Pet Name

Type (dog, cat, etc.) * Required

Sex * Required

Male

Female

Neutered/Spayed * Required

Yes

No

Unknown

Breed * Required

Age - Year * Required
Please enter a number from 0 to 12.

Age - Month * Required
Please enter a number from 0 to 12.

Weight * Required

Color/Features * Required

Hair Length/Type * Required

Collar (type & color)

Tags on Collar

Microchip Information

Additional Information

Lost Information:

Lost Date - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY

Lost Time

: Hours

Minutes

AM/PM

Today’s Date - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY

Today's Time

: Hours

Minutes

AM/PM

Address Lost From * Required
Street City

Attach a photo of your pet * Required
Photos that show clear pictures of their head, body, and any special markings are most helpful

Drop files here or

Accepted file types: jpg, gif, png, pdf, tiff, Max. file size: 256 MB.

Give Us a Call:

Office Hours:

Adoption Hours:

LOST ANIMAL REPORT FORM

262-782-9261

262-782-3356

Elmbrookhs@ebhs.org