Puppy Buyer Complaint Form

Did you buy a puppy who became sick?
Did you buy a puppy you believe may have come from a puppy mill?

Please tell us about yourself


*	First Name: Required
*	Last Name: Required
*	Email: Required
	Street 1:
	Street 2:
	City:
	State / Province:
	ZIP / Postal Code:
	Country:
	Phone Number:
	Yes, please send me action alerts, updates, and special offers to help animals. PLEASE NOTE: If you currently get emails from us, unchecking this box means you will no longer hear from us.

Pet Store Info (If Applicable)

Question - Not Required - Store name:

Question - Not Required - Store Street 1:

Question - Not Required - Store Street 2:

Question - Not Required - Store City:

Question - Not Required - Store State/Province:

Question - Not Required - Store Zip/Postal Code:

Question - Not Required - Store Country:

Question - Not Required - Store Phone Number:

Question - Not Required - Store Website:

Breeder Info (If Applicable)

Question - Not Required - Breeder Name:

Question - Not Required - Breeder Street 1:

Question - Not Required - Breeder Street 2:

Question - Not Required - Breeder City:

Question - Not Required - Breeder County:

Question - Not Required - Breeder State/Province:

Question - Not Required - Breeder Zip/Postal Code:

Question - Not Required - Breeder County:

Question - Not Required - Breeder Phone Number:

Question - Not Required - Breeder Website:

Question - Not Required - Breeder Email:

Please tell us about your experience.

Question - Not Required - Did you look at the pet seller's website before purchase?

Question - Not Required - Did you buy the puppy over the internet?

Question - Not Required - How much did your puppy cost?

Question - Not Required - How much in vet bills have you accrued?

Question - Not Required - Did you get a refund?

Question - Not Required - If yes, how much?

Question - Required - Story details:

Question - Not Required - Do you consent to being contacted by The HSUS or other parties, such as the media, to share your story? Your contact information will not be used for fundraising purposes.

Question - Not Required - Restrictions:

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Puppy Buyer Complaint Form