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2. Date Lost*
   Date Lost
   What date did your animal go missing
3. Type of Pet

   1. Dog
   2. Cat
   3. Other
4. Description
   What "other" type of pet are you missing
6. Pet Name
7. Picture of Pet
9. Location Lost*
10. Nearest Cross Street
14. OWNER INFORMATION
16. Last Name*
17. First Name*
19. Address
    Enter your house numbers
20. Street Name
21. Zip Code
23. Phone number*
24. Email*
25. Permission to Release Contact Information *
    -- Select One --YesNo

    Do you authorize the Citrus Heights Police Department to release this information to a finding party if we are able to match a FOUND report with a LOST report?
29. ANIMAL DESCRIPTION
31. Sex*

    Check all that apply

    1. Male
    2. Female
    3. Fixed
    4. Intact
32. Breed
33. Age Group*
    -- Select One --Juvenile (< 6mos)Young Adult (6 mos - 1yr)Adult (1-8yrs) Senior (8+ yrs)
35. Color*
36. Coat Length

    1. Short
    2. Medium
    3. Long
40. ANIMAL IDENTIFICATION
42. Collar

    Was your pet wearing a collar when it went missing?

    1. Yes
    2. No
43. Description
    Color and material of collar
45. ID tag

    Was your pet wearing an ID tag when it went missing?

    1. Yes
    2. No
46. Description
    Describe the ID tag. What info does it contain?
48. Microchip

    Does your animal have a microchip?

    1. Yes
    2. No
49. Microchip Number
    Enter Microchip Number
51. Has your animal ever shown aggression*

    1. Yes
    2. No
52. Aggression Shown Toward

    1. People
    2. Other Animals
54. Has your animal ever bitten a person?*

    1. Yes
    2. No
55. When did the bite occur
    When did the bite occur
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field