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Your Information


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Animal Information









(List name or location of place, such as pet store, parking lot, at breeder’s kennel, or via phone or website.)

(List name of advertising source, such as classified ad in newspaper, online service, AKC.)

Breeder Information








Situation Information


Be specific and factual when explaining your dog’s or cat’s health condition following purchase (or rescue/foster) and during the recovery period. List illnesses and treatments, physical and psychological.



Describe interactions before, during and after purchase (or rescue/ foster), including what false information was provided to you.

Please list contacts, if any, with local law enforcement, city, county or State legislators or personnel, local humane society, MN Board of Animal Health or others and describe what actions were taken on your behalf.

PLEASE NOTE: By completing this form you are giving us permission to possibly submit your story to authorities. We will contact you prior to any action being taken.

Thank you. Your efforts will make a difference.