Approve to Publish
Yes No
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If you approve us to publish your complaint so that it will be visible to the general public on our website please check yes. Note that we ill not publish personal/contact information about you, but we will publish your name.
About You
First Name (*)
Required
Last Name (*)
Required
Your Phone (*)
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Email Address (*)
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Address Line 1 (*)
Required
Address Line 2
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City (*)
Required
State or Province
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Zip or Postal Code (*)
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Country (*)
Canada United States Other
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How should we contact you?
E-mail Phone
About the Shop / Purchase
Was this an online purchase?
Yes No
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Shop Name (*)
Required
Shop Address Line 1 (*)
Address required.
Shop Address Line 2
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Shop State or Province
Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
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Shop City (*)
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Shop Zip or Postal Code (*)
Required
Shop Country (*)
Canada United States Other
Required
Name of shop country if other?
Shop Website
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Shop Email Address
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About the Companion Animal
Price (if known)
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Breed (*)
Required
Sex (*)
Female Male
Required
Enter your best guess if you don't know the date of birth or purchase
Breeder (*)
Required (best guess if don't know)
Broker
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The Situation and Your Experience
Registry
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Diseases and Illnesses (*)
Required Field
When did illnesses begin and end? (*)
Response required
Hereditary Defects?
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Did the pet shop or kennel recommend this vet? (*)
Yes No N/A
Required
Veterinary expenses to date (*)
Required
How did you hear about this pet shop, kennel or online merchant? (*)
Required
Please describe the conditions in the pet shop or kennel, such as housing, space availability, food, water, bedding, cleanliness, temperature, health and demeanor of the animals, and exposure to illness and disease:
Enter Description Here (*)
Required field
Complete this section only if this was an Eastern European Purchase
Was this an Eastern European purchase?
Yes No
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Breeder's Name
Shop Name
Breeder's Email Address
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Breeder's Address Line 1
Address required.
Breeders Address Line 2
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Breeder's City
City Required
Breeder's Zip or Postal Code
Zip or Postal Code Required
Breeder's Country
Breeder's Website
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Can the dog be registered with an American registry (APRI, ACA, etc.)?
Yes No N/A
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Did the pet shop tell you that the dog could be registered with AKC?
Yes No N/A
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Did the pet shop promote the dog as coming from European championship lineage?
Yes No N/A
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Do you feel you paid more or were you told the dog was more expensive because the dog was imported?
Yes No N/A
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