Neglect Report Form :: Programs & Services :: Willamette Humane Society

Neglect Report Form

WHS investigates allegations of animal abuse and neglect in Marion and Polk Counties. If you believe you’ve witnessed a crime involving animals, provide the following information as completely as possible to initiate an investigation. Due to the confidential nature of our investigations, you will not receive any information regarding the results of any investigation. WHS investigators are committed to spending as much time as possible in the field and our goal is to begin an investigation within 48 hours.

Animal Description

Cat

Dog

Small Pet

Horse

Livestock

Other

Number of animals:

Color:

Breed (if known):

Physical condition of the animal(s)

Thin

Injured

Sick

Please explain situation

Animal's Environment

Shelter

Water

Food

Environmental issues:

Feces

Flies

Trash

Muddy

Wet

Confinement:
Other:

Other details you would like to share:

Owner information

Owner's Name:

Owner's Address: *

Owner's City: *

Owner's State:

Owner's Zip:

Owner's Phone Number:

Owner's Property Description (house color, fencing, etc.)

Is property posted with a No Trespassing sign?

Is the animal(s) visible from the road?

Vehicle description

(If a vehicle is associated with the owner or animal(s))

Vehicle type:

Color:

Make & Model

Your Contact Information

Name: *

Email Address: *

Address 1:

Address 2:

City:

State:

Zip:

Primary Phone Number:

Secondary Phone Number:

Other additional information

More information:

Fields marked with * are required.

Willamette Humane Society Strengthening the bond between pets and people

Neglect Report Form

Contact Information

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