| Douglas County Animal Care & Services921 Dump Rd. Gardnerville, NV 89410 (775) 782-9061 | 
| Date Reported* | Date Missing* | 
| Pets Name | Age | Weight | 
| Sex* | Spayed/Neutered* | 
| Breed (list top two if mix)* | 
| Color(s) & Other Details* | 
| Where was the pet last seen?* | 
| Collar/Leash - Describe | License # | 
| Rabies Tag # | Microchip # | 
| Owner Information | 
| First Name* | Last Name* | 
| Address | 
| City | State | Zip | 
| Home Phone* | Work Phone | Cell Phone | 
| Veterinarian's Name | Veterinarian's Phone | 
|  Receive email copy   Email address This field is not part of the form submission. |