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 concern Did 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 incident Type of animal(s) Dog Cat Other Other type Number of animals Description 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 suspect Name First Middle Last Address Street Address City State / Province / Region ZIP / Postal Code Phone (Primary)Phone (Secondary)Email Vehicle Description Vehicle Model Vehicle Color License Plate Other Conditions I do not wish to be contacted. I would like to hear from a Humane Officer about this report.