Please provide the following information. (Name and phone are required to submit a concern. This information will remain completely confidential unless you sign a written release):
* Denotes required fields.
Please provide as much of the below information as possible for the animal care provider:
Type of animal(s) involved: (select all that apply)
Type of animal care concern: (select all that apply)
Have you contacted the owner regarding this concern?
Have you contacted local law enforcement regarding this report?
Do you have any documentation regarding this concern?
Does anyone else have information regarding this specific concern?
Do you want us to follow up with you regarding the outcome of this report?
Is there additional information that would be helpful for our response team to address this case?