Dog Park Complaint Submit Form: (use to report issues that happen at either of our Dog Parks)

Edit Form

PLEASE TELL US ABOUT YOURSELF (submitter's information)

Name

Address

City

State

Phone

Email (required)*

Ok to Contact me

Yes

No

On this Date

Day of the Week

Time

Which Dog Park was this at

Simi Dog Park

Oak Canyon Dog Park

Location

Big Dog Side

Small Dog Side

THE FOLLOWING INCIDENT OCCURRED

PLEASE DESCRIBE THE DOG THAT CREATED THE PROBLEM

Dog Name if known

Breed/Type if known

Color(s) of Dog

Sex:

Age

Size

Dog Tag/License if known

Weight

Distinguishing Characteristics

Miscellaneous Information

PLEASE TELL US ABOUT THE PERSON WITH THE DOG (if known)

Name of the person with Dog

Was the person with the Dog the owner?

Their phone #

Their Car license plate #

Car License State

Car Make

Car Model

Car Color(s)

WHERE THERE WITNESSES?

Yes

No

Witness Name #1

Witness Phone #1

Witness Name #2

Witness Phone #2

Witness Name #3

Witness Phone #3

Attach Photo (optional)