Lost Animal Questionnaire

Date Lost
Area Lost
Age Group	0 - 6 Months 6 Months - 8 Years 8 Years and over
Actual Age
Sex	Male Female
Species	Cat Dog
Breed	Akita Alaskan Malamute American Bulldog American Eskimo Dog American Staffordshire Terrier American Water Spaniel Anatolian Shepherd Australian Kelpie Australian Shepherd Australian Terrier Basenji Basset Hound Beagle Bearded Collie Beauceron Bengal Black and Tan Coonhound Black Labrador Retriever Black Mouth Cur Bloodhound Blue/Red Heeler Bluetick Coonhound Bobtail Border Collie Border Terrier Boston Terrier Boxer Bullmastiff Bull Terrier Bunny Rabbit Burmese Cane Corso Mastiff Carolina Dog Catahoula Leopard Dog Cattle Dog Chesapeake Bay Retriever Chicken Chihuahua Chocolate Labrador Retriever Chow Chow Cocker Spaniel Collie Coonhound Corgi Cornish Rex Dachshund Dalmatian Devon Rex Doberman Pinscher Domestic Long Hair Domestic Medium Hair Domestic Short Hair Duck English Bulldog Exotic Shorthair Foxhound Fox Terrier French Bulldog German Pinscher German Shepherd Dog German Shorthaired Pointer German Wirehaired Pointer Golden Retriever Goose Great Dane Great Pyrenees Greyhound Himalayan Hound Husky Irish Setter Irish Terrier Jack Russell Terrier Komondor Labrador Retriever Maine Coon Maltese Mastiff Miniature Pinscher Mixed Breed Munchkin Ocicat Papillon Peacock/Pea fowl Pekingese Persian Pheasant Pit Bull Terrier Plott Hound Pointer Pomeranian Poodle Pug Ragdoll Redbone Coonhound Retriever Rhodesian Ridgeback Rottweiler Russian Blue Saint Bernard St. Bernard Schnauzer Setter Shar Pei Sheep Dog Shepherd Shih Tzu Siamese Siberian Husky Skunk Spaniel Sphynx (hairless cat) Staffordshire Bull Terrier Swan Terrier Treeing Walker Coonhound Turkey Weimaraner Whippet White German Shepherd 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 Tortie Blue Blue Tortie Brindle Brindle and Black Brindle and White Brown Brown and Black Brown and White Chocolate Chocolate Tortie Cinnamon Cinnamon Tortoiseshell Cream Fawn Fawn Tortoiseshell Ginger Ginger and White Golden Green Grey Grey and White Light Amber Lilac Lilac Tortie Liver Liver and White Ruddy Seal Silver Sorrel Sorrel Tortoiseshell Tabby Tabby and White Tan Tan and Black Tan and White Tortie Tortie and White Tricolour Various White White and Black White and Brindle White and Brown White and Grey White and Liver White and Tabby White and Tan White and Torti Yellow and Grey
Markings or distinguishing features
Features
Microchipped	Yes No
Neutered	Yes No
Collar	Yes No
Color of collar
Name
Name and Address
Title	Mr Mrs Ms Miss
First name
Last name
Address
Postcode
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