General Animal Concern Have you filed a report with another agency regarding this incident/concern? Yes No If yes, which one?Type of concern you are reporting (check all that apply) Animal-to-person bite Animal-to-animal bite Animal running at large Barking complaint Aggressive/vicious animal Welfare concern Other Other type of concernDid you personally witness the incident? Yes No Date of the incident MM slash DD slash YYYY Time of the incident Hours : Minutes AM/PM AM PM AM/PM Ongoing Issue Yes Location of incidentType of animal(s) Dog Cat Other Other typeNumber of animalsDescription of animal(s) (color/size/breed)Summary of incident/concernPlease know that your personal information is kept confidential. In the event we have additional questions or need to follow up about a concern, we will need your contact information to do so. Your InformationI would prefer to remain anonymous I would prefer to remain anonymous Date Reported MM slash DD slash YYYY Name First Middle Last Address Street Address City State / Province / Region ZIP / Postal Code Phone (Primary)Phone (Seconday)Email Animal Owner/Suspect InformationUnknown Unknown Relationship to suspectName First Middle Last Address Street Address City State / Province / Region ZIP / Postal Code Phone (Primary)Phone (Secondary)Email Vehicle DescriptionVehicle ModelVehicle ColorLicense PlateOtherConditions I do not wish to be contacted. I would like to hear from a Humane Officer about this report. Δ