JCHS Lost Pet Form

Estimated Date Missing

Month

Day

Year

Animal Type

Animal Age

Animal Breed

Animal Name?

Animal Color/Colors?

Is the animal Spayed or Neutered?

Yes

No

Is this animal microchipped?

Yes

No

Did they have a collar?

Yes

No

If your pet had a collar what color/type?

Does this animal have any distinguished characteristics?

If your animal is NOT friendly toward any of the people or animals listed above, or if a situation is not listed, please explain.

When (Days, weeks or hours) and Where (Location went missing) did your pet go missing?

I give Jefferson County Humane Society permission to post my lost animal/animals on their Facebook page and other Facebook groups.

No, I do not wish for my lost pet to be posted on Facebook or any other social media platforms through Jefferson County Humane Society. Please keep my information and my pet's information private.

Yes, I authorize Jefferson County Humane Society to post my lost pet on its Facebook page and share it with other lost pet groups. I understand that only my name and phone number may be shared publicly to help reunite me with my pet. No other personal information may be disclosed.

Animal Photo

Owner Information

First name

Last name

Contact Phone #

Email

Address

Apt./Lot #

City & State

Zip Code