ALAS Lost Animal Questionnaire

First name *
Last name *
Address *
City *
State *
Zip Code *
Mobile Phone *
Home Telephone
Email address * Please provide your email so that we can contact you.
Date Lost *
Area Lost *
Species *	Cat Dog
Breed *	Abyssinian Affenpinscher Afghan Hound Airedale Terrier Akbash Akita Alaskan Malamute American Bulldog American Eskimo Dog American Staffordshire Terrier American Water Spaniel Anatolian Shepherd Applehead Siamese Australian Cattle Dog/Blue Heeler Australian Shepherd Australian Terrier Balinese Basenji Basset Hound Beagle Bearded Collie Belgian Shepherd Dog Sheepdog Belgian Shepherd Laekenois Belgian Shepherd Malinois Belgian Shepherd Tervuren Bernese Mountain Dog Bichon Frise Birman Black and Tan Coonhound Black Labrador Retriever Black Mouth Cur Bloodhound Blue Heeler Bluetick Coonhound Bobtail Bombay Border Collie Border Terrier Boston Terrier Bouvier des Flanders Boxer Boykin Spaniel British Shorthair Brittany Spaniel Brussels Griffon Bullmastiff Bull Terrier Burmese Cairn Terrier Calico Canaan Dog Cane Corso Mastiff Carolina Dog Catahoula Leopard Dog Cattle Dog Cavalier King Charles Spaniel Chartreux Chesapeake Bay Retriever Chihuahua Chinese Crested Dog Chinese Foo Dog Chocolate Labrador Retriever Chow Chow Clumber Spaniel Cockapoo Cocker Spaniel Collie Coonhound Corgi Coton de Tulear Cymric Dachshund Dalmatian Dandi Dinmont Terrier Doberman Pinscher Dogo Argentino Dogue de Bordeaux Domestic Long Hair Domestic Medium Hair Domestic Short Hair Doodle Dutch Shepherd English Bulldog English Cocker Spaniel English Coonhound English Pointer English Setter English Shepherd English Springer Spaniel English Toy Spaniel Entlebucher Eskimo Dog Exotic Shorthair Extra-Toes Cat (Hemingway Polydactyl) Ferret Field Spaniel Finnish Spitz Flat-coated Retriever Foxhound Fox Terrier French Bulldog German Pinscher German Shepherd Dog German Shorthaired Pointer German Wirehaired Pointer Golden Retriever Gordon Setter Great Dane Greater Swiss Mountain Dog Great Pyrenees Greyhound Havana Havanese Heeler Himalayan Hound Husky Ibizan Hound Irish Setter Irish Terrier Irish Water Spaniel Irish Wolfhound Italian Greyhound Jack Russell Terrier Japanese Bobtail Japanese Chin Javanese Kerry Blue Terrier Kishu Kokoni Komondor Korat Kuvasz Labrador Retriever Lakeland Terrier Lancashire Heeler Lhasa Apso Maine Coon Maltese Manx Mastiff Miniature Pinscher Mixed Breed Mountain Cur Mountain Dog Munchkin Neapolitan Mastiff Nebelung Newfoundland Dog New Guinea Singing Dog Norfolk Terrier Norwegian Buhund Norwegian Elkhound Norwegian Forest Cat Norwegian Lundehund Norwich Terrier Nova Scotia Duck-Tolling Retriever Old English Sheepdog Otterhound Papillon Patterdale Terrier (Fell Terrier) Pekingese Persian Peruvian Inca Orchid Petit Basset Griffon Vendeen Pharaoh Hound Pit Bull Terrier Pixie-Bob Plott Hound Pointer Polish Lowland Sheepdog Pomeranian Poodle Portugese Podengo Portuguese Water Dog Presa Canario Pug Puli Pumi Ragamuffin Ragdoll Rat Terrier Redbone Coonhound Retriever Rhodesian Ridgeback Rottweiler Russian Blue Saint Bernard St. Bernard Saluki Samoyed Schipperke Schnauzer Scottish Deerhound Scottish Fold Scottish Terrier Scottie Sealyham Terrier Setter Shar Pei Sheep Dog Shepherd Shetland Sheepdog Sheltie Shiba Inu Shih Tzu Siamese Siberian Siberian Husky Silky Terrier Skye Terrier Smooth Fox Terrier Snowshoe South Russian Ovcharka Spaniel Spitz Staffordshire Bull Terrier Swedish Vallhund Terrier Thai Ridgeback Tibetan Mastiff Tibetan Spaniel Tibetan Terrier Tonkinese Tosa Inu Toy Fox Terrier Treeing Walker Coonhound Turkish Angora Turkish Van Vizsla Weimaraner Welsh Corgi Welsh Springer Spaniel Welsh Terrier West Highland White Terrier Westie Wheaten Terrier Whippet White German Shepherd Wire-haired Pointing Griffon Wirehaired Terrier Xoloitzcuintle/Mexican Hairless Yellow Labrador Retriever Yorkshire Terrier Yorkie
Color *	Amber Black Black and Brindle Black and Brown Black and Tan Black and White BLACK BLUE MERLE Black Tortie Blue Blue Tortie Brindle Brindle and Black Brindle and White BRINDLE - LIGHT/DILUTE Brown Brown and Black Brown and Red Brown and Tan Brown and White Brown Tabby Brown w/White - Tabby Buff Buff and White Calico Calico - Dilute Chocolate Chocolate Tortie Cinnamon Tortoiseshell Cream DILUTE BRINDLE Dilute Tortoiseshell Fawn Fawn Brindle Flame Point Golden Gray and Black Grey Grey and White Grey and White Tabby Grey Tabby Lilac Lilac Tortie Lynx Point Orange and White Tabby Orange Tabby RED RED AND WHITE RED MERLE SABLE Saddleback - BROWN Tabby w/White SADDLEBACK - ORANGE AND WHITE Seal Point Silver Snowshoe Tabico Tan Tan and Black Tan and Brown Tan and White Tortie Tortie and White Tortoiseshell Tricolour Tuxedo White White and Black White and Brindle White and Brown White and Buff White and Grey White and Orange White and Tan White and Torti WHITE BROWN-BLACK SPOTTED White w/Tabby Spots-Patches
Secondary Color	Amber Black Black and Brindle Black and Brown Black and Tan Black and White BLACK BLUE MERLE Black Tortie Blue Blue Tortie Brindle Brindle and Black Brindle and White BRINDLE - LIGHT/DILUTE Brown Brown and Black Brown and Red Brown and Tan Brown and White Brown Tabby Brown w/White - Tabby Buff Buff and White Calico Calico - Dilute Chocolate Chocolate Tortie Cinnamon Tortoiseshell Cream DILUTE BRINDLE Dilute Tortoiseshell Fawn Fawn Brindle Flame Point Golden Gray and Black Grey Grey and White Grey and White Tabby Grey Tabby Lilac Lilac Tortie Lynx Point Orange and White Tabby Orange Tabby RED RED AND WHITE RED MERLE SABLE Saddleback - BROWN Tabby w/White SADDLEBACK - ORANGE AND WHITE Seal Point Silver Snowshoe Tabico Tan Tan and Black Tan and Brown Tan and White Tortie Tortie and White Tortoiseshell Tricolour Tuxedo White White and Black White and Brindle White and Brown White and Buff White and Grey White and Orange White and Tan White and Torti WHITE BROWN-BLACK SPOTTED White w/Tabby Spots-Patches
Sex *	Male Female Unkown
Age Group *	0 - 6 Months 6 Months - 1 Year 1+ Years
Spayed or Neutered *	Yes No Unknown
Microchipped *	Yes No Unknown
Microchip Number
Markings or distinguishing features *
Collar *	Yes No
Collar Description *
Comments
Pictures *
Photo #2 *
Photo #3 *
Owner of Lost Pet(s) * That you are the lawful owner of the above animal(s).	Clear