Service Animal Misrepresentation Report Form
Report suspected service animal misrepresentation by providing detailed and accurate information below.
Date and time of the incident
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of the incident (business, address, or public area)
*
Description of the incident
*
Description of the animal (species, breed, color, size, distinguishing features)
*
Description of the animal's handler (appearance, behavior, relation to animal)
Reason you suspect misrepresentation
*
Did the animal display any disruptive or inappropriate behavior?
*
Yes
No
Not sure
Were any actions taken by staff or authorities?
Yes
No
Not sure
Upload any supporting files or photos (optional)
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Your name and contact information (optional)
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