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). Please skip any questions in the following sections you do not know the answer to, or simply skip to the "Please tell us about your experience" section if you prefer.

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 - Required - Did you buy the puppy over the internet?

Question - Not Required - Name of website or online classified site if not provided above? (example: eBay Classifieds, Craigslist, or other marketplace site)

(Maximum response 255 chars, approx. 5 rows of text)

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

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

Question - Required - Did you receive any reimbursement from the seller?

Question - Not Required - If yes, how much?

Question - Required - Did the seller require you to sign a form stating that you would not pursue any legal claims against them in exchange for getting reimbursement?

Question - Required - What date or in what year did you purchase your puppy?

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:

* indicates required field

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The Humane Society of the United States is registered as a 501(c)(3) non-profit organization. Contributions to The Humane Society of the United States are tax-deductible to the extent permitted by law. The HSUS's tax identification number is 53-0225390.