Animal Custody Dispute

Do you currently have possession of the pet? Yes/No If no, last date you had possession of the animal. What is your relationship with the other party? Who purchased the animal? Is the animal an ESA or Service Animal? Yes/ No If so, please describe. Is the animal licensed with the city? Yes/ No Please describe. Is the animal microchipped? Please describe. Who pays for the care of the animal?

Dog Bite or Dangerous Animal Issue

Have you been contacted by Animal Control? Yes/ No Have you received a ticket from Animal Control? Yes/No If so, what is your next court date? (located on your ticket) Which courthouse is listed on your summons? What are the charges listed on your ticket? Do you currently have possession of your dog? Yes/No If no, what date was your dog impounded by animal control? Have you received a demand letter or were you served a complaint? Yes/ No What date did you receive the demand letter of the Complaint? Name of the other parties attorney, if applicable. Do you have homeowners insurance? Yes/ No If yes to insurance; Have you contacted your insurance carrier about this incident? Yes/ No Do you have coverage for your animal? Yes/No Was a person or another animal injured? Yes/ No Was a person or another animal killed? Yes/ No Please briefly describe the incident and any injuries. Have you had any previous animal control violations or allegations? Yes/ No If yes, please provide a brief list of any previous cases. Are there any damages alleged in this case? If so, please provide an estimate.

Service Animal or ESA Discrimination

Do you identify as having a disability recognized under the Americans with Disabilities Act (ADA) or Colorado law? A disability is defined as “a physical or mental impairment that substantially limits one or more major life activities.” Y/N Briefly describe your disability (optional): What is the animals designation? Please select: Service Animal / Emotional Support Animal / Therapy or Companion Animal? What tasks is the animal trained to perform? Who trained the animal? Please select: Professional Trained / Self-trained Location of incident? Type of location? Please select: Housing / Public Business / Employment / Transportation / Other (Please describe ) Name of Business/Property/Entity? Contact Person (if known)? Were you denied access, services, or housing because of your service animal or ESA? Please describe: Was the animal behaving appropriately at the time (not disruptive or aggressive)? Yes/ No

Other Animal issue

Contact information: Contact 1: You

Gender

Your Pronouns

Other Party (if known)

Name

Phone Number

Email Address

Information About Your Case

1. What kind of Animal Issue are you reaching out to us about?

Information on animals involved

Name:

Species:

Breed:

Date of incident:

Please briefly describe the incident:

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