Lost Animal Report Form

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CEDAR RAPIDS ANIMAL CONTROL
LOST ANIMAL REPORT FORM

If you have questions or need assistance with this form please contact Animal Control at 319-286-5993 or email at animalcontrolstaff@cedar-rapids.org

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TYPE OF REPORT
Is this a new report, or a report renewal?*

WHEN/WHERE THIS ANIMAL WAS LOST
Each field is required. Please type N/A if it doesn't apply to you.

Date the animal was lost:*

Describe the Circumstances:*

Street/Section:*

City:*

ANIMAL DESCRIPTION
Type of animal*

If Other, what type?

Breed:

Color:

Special color markings:

Age:

Sex/Status:*

Approximate weight:*

Animal Size:*

Fur:*

Tail:*

Ears:*

Special Markings (Select all that apply):

Scars

Nick in ears

Eye colors

Declawed

Deaf

Blind

Limps

Vocal

Hyper

Debarked

Stitches

Shaved patches

Skin condition

Overweight

Other

Identification:
Did the animal have a collar?*

Describe type/color:

Owner ID:

License:

Tattoo:

Microchip:

Vet/Rabies Tag:

Other types of collar:

To help us identify lost pets, please attach a photo of the animal:

OWNER INFORMATION

Name:*

Address:*

City:*

Daytime Phone #:*

Evening/Mobile Phone #:*

ACKNOWLEDGEMENT OF REPORT RETENTION I understand that this report will be held on file with Cedar Rapids Animal Care and Control for a period of 30 days. If I wish for this report to remain active past 30 days, it is my responsibility to file the report again as a “Report Renewal.” All reports will be discarded and destroyed after 30 days.

Please Initial Your Acknowledgement Here:*

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