Longmont Humane Society
Lost Dog Report
Date Lost (M/D/YYYY)
City Lost
Location Lost
(give closest major intersection)
Dog Description
Name
Breed
Gender
Female
Male
Altered
Yes
No
Age
Years
Months
Color
Eye Color
Size
XS
S
M
L
XL
XXL
Weight
pounds
Coat
Short
Medium
Long
Silky
Wiry
Curly
Wavy
Shaved
Groomed
Ears
Erect
Droopy
Folded
Cropped
Semi-Erect
1-up/1-down
Tail
None
Short
Docked
Short/Curly
Medium
Long
Long/Curly
Face
Flat Muzzle
Pointy Muzzle
Square Muzzle
Massive Head
Droopy Lips
Large Eyes
Wrinkles
Face (other)
Collar
Yes
No
Color
Style
Tags
Yes
No
Rabies
City License
ID
Microchip?
Yes
No
Comments
Owner Contact Information
Fields labeled with a red asterisk (
*
) are required. At least one telephone number is required in order that we may contact you regarding your lost dog. If you supply an email address, you will receive a copy of the report for your records.
First Name
*
Last Name
*
Address
*
Email
City
*
Zip
*
Home Phone
*
Cell/Work Phone
*
Alternate Contact
Phone
