Report Animal Cruelty This form is used to report animal cruelty to Emerald Shores Humane Society. HiddenNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.In order to provide a thorough and professional investigation, Emerald Shores Humane Society must have good quality information. This complaint form will help you provide that information to us.In accordance with Florida law, the Emerald Shores Humane Society will not respond to anonymous complaints of animal cruelty.Your Name(Required) First Last Your Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code YOUR CONTACT INFORMATIONOur investigator must be able to make contact with you and speak with you to gather additional information regarding this complaint. If we are unable to reach you, we will not be able to investigate your complaint.Phone Number(Required)Provide us with the best number to reach you.Your Email Address(Required) Email Address Confirm Email Address Your Phone(Required)COMPLAINT INFORMATIONThis section is where you will provide us with the details of your complaint. Date of Occurrence MM slash DD slash YYYY When did the incident occur?Time of Occurrence Hours : Minutes AM PM AM/PM What time did the incident occur?Tell us the names of the people involved and their roles in the incident. If you do not know their names, please provide a physical description of them.(Required)Provide us with a description of the animal(s) involved in this complaint. If you know the name of the owner of the animal, please provide it as well.(Required)Tell us what happened.(Required)Supporting EvidencePlease upload any photos, documents, or other evidence to support your complaint. If you have more evidence than you can upload here, please e-mail the information to [email protected].Evidence Item #1Max. file size: 100 MB.Evidence Item #2Max. file size: 100 MB.Evidence Item #3Max. file size: 100 MB.Evidence Item #4Max. file size: 100 MB.
