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Lost Dog eForm
Please note * denotes a mandatory field
Reference Code: 0USI2S2E9687
Personal Details
Title:    
* Forename:  
* Surname:  
* Address Line 1:  
Address Line 2:
* Town / City:  
* Post Code:    
* Home Telephone Number:    
Work Telephone Number:  
Mobile Telephone Number:  
Email Address:  
Dog Details
* Name:    
* Breed:          
* Age:    
Sex:  
* Size:    
* Colour Markings:    
Is the dog chipped:  
Does the dog wear a tag or disc:  
  Is the dog neutered or spayed:
You may qualify for either free neutering or reduced price neutering, for further information please call (01709) 823118		  
Further / Additional Information
To help us identify your dog better you can upload a picture.  To use this facility please have a .JPG or .GIF file ready to upload and send.  Please make sure the file is no larger then 1Mb in size (it will fit easily onto a floppy disk drive) as it will not upload.
Once submitted successfully you will be re-directed to the following page: http://www.rotherham.gov.uk/graphics/Environment/Stray+Dogs