The Humane Society of Louisiana
 
 
 

ANIMAL CRUELTY OR NEGLECT REPORT FORM

Please fill out the form as completely as possible, to aid us in our investigation. We do accept anonymous complaints, but it is very useful for us to have your name and contact information, in the event we need further details.

The identity of a witness or a complainant is kept strictly confidential, unless he or she is willing to testify in court and/or unless he or she specifically gives us permission to reveal their name in the course of the investigation.

If applicable, please photograph, email and/or send us pictures of the animal(s) to help us better assess and document the abuse or neglect situation.

HUMANE SOCIETY OF LOUISIANA
ANIMAL CRUELTY REPORT

ABOUT YOU:

Is this an anonymous complaint?

Will you provide us with contact information,
if we keep your name confidential?


ABOUT YOU:

  FIRST NAME:
  LAST NAME:
  STREET:
  CITY:
  PARISH:
  STATE:
  ZIP:
  EMAIL:
  HOME PHONE:
  CELL PHONE:
  WORK PHONE:
  ARE YOU A WITNESS TO THIS CRIME?
  ARE YOU WILLING TO GIVE A WRITTEN STATEMENT AND TESTIFY IN COURT, IF NEEEDED?
 

ABOUT THE CRUELTY OR NEGLECT COMPLAINT:

TYPE OF ANIMAL(S) (Give species, breed, number(s) and/or description):


DATE(S) OF THE INCIDENT/PLEASE INDICATE IF ONGOING:


PLEASE DESCRIBE THE INCIDENT IN YOUR OWN WORDS:



COMPLETE ADDRESS WHERE INCIDENT
TOOK PLACE OR IS NOW HAPPENING:

ADDRESS:
CITY :
PARISH:
STATE:
ZIP:  
DIRECTIONS TO THIS LOCATION :
ARE THERE WITNESSES TO THIS CRIME. IF SO, WHO WE SHOULD CONTACT? PLEASE GIVE US NAMES AND DETAILS:

HAS ANY OTHER ENFORCEMENT AGENCY BEEN CONTACTED ABOUT THIS CASE?

IF SO, WHAT AGENCY?

PLEASE GIVE CONTACT INFORMATION FOR INVESTIGATION OFFICER : (IF KNOWN)


WHAT HAS TRANSPIRED SO FAR, IN REGARD TO THIS INVESTIGATION?

   
ABOUT THE OWNER OR KEEPER OF THE ANIMAL (IF KNOWN)
FIRST NAME:
LAST NAME:
STREET:
CITY:
PARISH:
STATE:
ZIP:
EMAIL:
HOME PHONE:
CELL PHONE:
WORK PHONE:
WHEN IS THE OWNER GENERALLY HOME?

IF THE OWNER/KEEPER IS NOT KNOWN, IS THERE ANY INFORMATION ABOUT THE ALLEGED PERPETRATOR YOU CAN GIVE US?

IS THERE ANYTHING ELSE YOU WOULD LIKE TO ADD?

In addition to pressing submit below, if you have any pictures of this abuse, please email the picture to: cruelty@humanela.org