Summary. Sixteen templates, by situation.
1. Bite incident report
Complete the same day. This is the document everything else is built on.
INCIDENT REPORT — complete within 24 hours
Prepared by: ______________ Date prepared: ____/____/______
THE INCIDENT
Date: ____/____/______ Time: ________
Location (exact): ______________________________
Weather / lighting: ______________________
MY ANIMAL
Name: ______________ Breed/description: ______________
Age: ____ Weight: ____ Sex: ____ Altered: Y / N
Microchip: ______________ License: ______________
Rabies vaccination date: ________ Certificate located: [ ]
Prior bite or aggression history: NONE / ______________________
THE OTHER PERSON
Name: ______________________
Address: ______________________
Phone: ______________ Email: ______________
Age (if a child): ____
Injury described: ______________________________
Medical care: [ ] declined [ ] urgent care [ ] ER [ ] EMS called
Where treated: ______________________
WHAT HAPPENED — chronological, factual, no conclusions
Before: ______________________________________________________
______________________________________________________________
During: ______________________________________________________
______________________________________________________________
After: ______________________________________________________
______________________________________________________________
Where was the animal confined? ______________________
How did the animal come into contact with the person?
______________________________________________________________
Was a gate, door, leash, or fence involved? ______________________
Who was present? ______________________
Was the person on my property? [ ] invited [ ] uninvited [ ] public
FACTS RELEVANT TO DEFENSES — record these even if you are not sure
Provocation: did the person strike, tease, corner, or startle the
animal? ______________________________
Trespass: was the person lawfully present? ____________
Defense of a person: was anyone being threatened? ____________
Defense of young: were puppies or kittens present? ____________
Prior conduct of the person toward the animal: ____________
WITNESSES
Name ______________ Phone ______________ What they saw ____________
Name ______________ Phone ______________ What they saw ____________
WHAT WAS SAID
By me: ______________________________
By the other: ______________________________
By any witness: ______________________________
PHOTOGRAPHS TAKEN (before anything was moved or repaired)
[ ] Location, wide [ ] Gate / door / latch
[ ] Fence, with height [ ] Leash and collar
[ ] Sight lines [ ] Any signage
Photo numbers: ______ to ______
REPORTS
Animal control notified: ____/____/______ Case # ____________
Police notified: ____/____/______ Report # ____________
Quarantine ordered: [ ] Yes — terms: ______________ [ ] No
INSURER NOTIFIED: ____/____/______ Claim # ____________
<- do this promptly; late notice is a coverage defense
WHAT I DID NOT DO
[ ] I did not admit fault or promise payment
[ ] I did not repair or alter the gate/fence before photographing
[ ] I did not speak to their insurer
[ ] I did not rehome or surrender the animal
2. Witness statement
WITNESS STATEMENT
I, ______________, of ______________________________, state:
1. On ____/____/______ at approximately ________, I was at
______________________ because ______________________.
2. WHAT I SAW. [In your own words, in order. Describe only what you
personally observed. Do not characterize; describe.]
______________________________________________________________
______________________________________________________________
______________________________________________________________
3. WHERE I WAS. I was approximately ______ feet away, at
______________________. My view was [unobstructed / partially
obstructed by ____________].
4. WHAT I HEARD. ______________________________________________
5. WHAT HAPPENED IMMEDIATELY BEFORE.
______________________________________________________________
6. [If applicable] MY KNOWLEDGE OF THE ANIMAL. I have known this animal
for ______ [time]. In that time I have observed:
______________________________________________________________
I have [never / ____ times] seen it behave aggressively toward a
person.
I declare under penalty of perjury that this statement is true and
correct to the best of my knowledge.
______________________ · [Phone] · [Address] Date: ________
NOTE: each statement should be in the witness's own words and should
differ from the others. Identical statements from several people are
worse than none.
3. Insurance notice letter
[Date] SEND PROMPTLY — LATE NOTICE IS A COVERAGE DEFENSE
[Insurance company]
[Claims address / claims email / claims phone]
RE: Notice of potential claim
Policyholder: ______________
Policy number: ______________
Date of incident: ____/____/______
Location: ______________________________
I am providing notice of an incident that may result in a claim under my
[homeowner's / renter's] liability coverage.
WHAT HAPPENED
On ____/____/______ at approximately ________, at
______________________, my dog [name, breed, age] came into contact
with ______________ [name], who sustained ______________________.
[Two or three factual sentences. Do not speculate about fault. Do not
characterize the injury beyond what you observed or were told.]
THE OTHER PERSON
Name: ______________ Address: ______________
Phone: ______________
Medical care: ______________________
REPORTS FILED
Animal control: case # ______________ on ________
Police: report # ______________ on ________
Quarantine ordered: [ ] Yes [ ] No
ENCLOSED
[ ] My written incident report
[ ] Photographs of the location
[ ] Rabies vaccination certificate
[ ] Witness contact information
[ ] Any correspondence received
I request that you:
1. Confirm receipt of this notice in writing.
2. Advise whether this incident is covered under my policy, and
identify any exclusion you contend applies.
3. Assign an adjuster and provide contact information.
4. Advise what you need from me.
I have not admitted fault, discussed settlement, or spoken with any other
insurer, and I will refer all contacts to you.
______________________ · [Phone] · [Email] · [Address]
Sent by [method] on ________; confirmation retained.
4. Ordinance review worksheet
Fill this out before doing anything else in a dangerous dog case.
ORDINANCE REVIEW
Jurisdiction: ______________ Code chapter: ______________
Found at: ______________________________ Date reviewed: ________
DEFINITIONS — quote them
"Potentially dangerous" means: ______________________________
"Dangerous" means: ______________________________
"Vicious" means: ______________________________
"At large" means: ______________________________
"Owner" / "keeper" / "harborer" means: ______________________
Does an "attack" require INJURY? Yes / No
Does it cover conduct toward OTHER ANIMALS? Yes / No
Is PROVOCATION in the definition or a defense? ____________
Is TRESPASS a defense? Yes / No
Defense of a person / of young? Yes / No
PROCEDURE
Who makes the initial determination? ______________________
Is the animal IMPOUNDED pending the hearing? Yes / No
Where: ______________ Daily cost to me: $ ______
Notice required? ______ days
Time to REQUEST a hearing: ______ days MY DEADLINE: ________
Hearing must occur within: ______ days
Who hears it: ______________________
Standard of proof: ______________________
Counsel permitted? Yes / No
May I present witnesses and cross-examine? Yes / No
CONSEQUENCES BY LEVEL — itemize
POTENTIALLY DANGEROUS: ______________________________
DANGEROUS: __________________________________________
Enclosure spec: ______________________
Insurance required: $ ______________
Muzzle / leash: ______________________
Signage: ______________________
Sterilization / microchip: ____________
Registration / registry: ______________
VICIOUS: ____________________________________________
Destruction possible? Yes / No
APPEAL
Route: ______________________
DEADLINE: ______ days <- WRITE THIS IN LARGE LETTERS
Filed where: ______________________
Is the designation stayed pending appeal? Yes / No
REMOVAL OF DESIGNATION
Possible? Yes / No After: ______ years Requirements: __________
OTHER SECTIONS TO CHECK
Leash / restraint: ______________________
Number limit per household: ______
Licensing: ______________________
Rabies vaccination: ______________________
Barking standard: ______________________
Waste: ______________________
Nuisance: ______________________
THE TWO NUMBERS THAT MATTER MOST
Deadline to request a hearing: ____/____/______
Deadline to appeal a decision: ____/____/______
5. Records request to animal control
[Date]
[Animal control agency / records custodian]
[Address]
RE: Request for records
Case number: ______________
Animal: ______________ Owner: ______________
Incident date: ____/____/______
I request copies of the following records concerning the above matter,
under [the state public records act / the ordinance's file access
provision]:
1. The complaint or report initiating this matter, in full
2. The investigating officer's complete report and field notes
3. All witness statements obtained
4. All photographs and video
5. Any medical records or descriptions of injury in the file
6. Any prior complaints, citations, or reports concerning this animal
or this address
7. Any prior determinations or designations concerning this animal
8. Impoundment records, including intake condition and daily care logs
9. Any communications between the agency and the complainant
10. The specific ordinance provisions relied on
11. Any documents the agency intends to introduce at the hearing
12. The name and qualifications of any witness the agency intends to
call
I request these in advance of the hearing scheduled for ____/____/______
so that I may prepare. If any record is withheld, please identify it and
state the basis.
If there is a fee, please advise the amount before processing.
______________________ · [Phone] · [Address] · [Email]
6. Temperament evaluation request
Give this to the behaviorist. It tells them what the hearing actually needs.
REQUEST FOR BEHAVIORAL EVALUATION — for use in an administrative hearing
Animal: ______________ Breed/description: ______________
Age: ____ Sex: ____ Altered: Y / N Weight: ____
Owner: ______________ Hearing date: ____/____/______
WHAT THE PROCEEDING IS
This is an administrative hearing to determine whether this animal
should be designated [potentially dangerous / dangerous / vicious]
under [jurisdiction] ordinance section ______. The ordinance defines
the relevant term as: "______________________________."
Possible consequences include: ______________________________.
WHAT THE EVALUATION SHOULD ADDRESS
Please address each of the following explicitly in a written report:
1. YOUR QUALIFICATIONS. Credentials, certifications, years of
practice, and experience evaluating animals for legal proceedings.
2. WHAT YOU DID. Dates, duration, setting, and the protocol used.
Please state the methodology by name where a standardized protocol
was used.
3. HUMAN-DIRECTED BEHAVIOR. Response to unfamiliar adults, to
children if safely assessable, to handling, restraint, and
approach; response to startling stimuli; resource guarding;
response to a stranger entering the space.
4. DOG-DIRECTED AND ANIMAL-DIRECTED BEHAVIOR, and whether it is
distinguishable from human-directed behavior.
5. AROUSAL AND RECOVERY. Threshold, intensity, and how quickly the
animal returns to baseline.
6. YOUR OPINION on whether this animal presents an unreasonable risk
of harm to people, stated in the terms the ordinance uses.
7. THE INCIDENT. Given the described circumstances [attach the
incident description], your professional opinion on the likely
behavioral explanation, including whether the described conduct is
consistent with predatory aggression, defensive behavior, fear,
redirected arousal, play, or startle.
8. MANAGEMENT RECOMMENDATIONS. Specific, implementable measures —
equipment, environment, handling, training — and your opinion on
whether they would reasonably mitigate any identified risk.
9. PROGNOSIS with the recommended management in place.
ENCLOSED FOR YOUR REVIEW
[ ] The incident report and any officer's report
[ ] Complete veterinary records
[ ] Training history
[ ] Statements from the groomer, boarder, and veterinary staff
[ ] Photographs of the home and enclosure
Please indicate whether you are willing to testify if requested, and
your fee for doing so.
7. Remediation package index
Assemble this BEFORE the hearing, and before the negotiation.
REMEDIATION PACKAGE
Owner: ______________ Animal: ______________
Case number: ______________ Hearing date: ____/____/______
TAB 1 — CONTAINMENT, COMPLETED
1.1 Photographs of the enclosure, with a measuring tape showing
height in the frame
1.2 Photographs of the gate, latch, and self-closing hardware
1.3 Photographs of posted signage
1.4 Contractor invoice and date of installation
1.5 Diagram of the property showing the enclosure and access points
TAB 2 — TRAINING, IN PROGRESS OR COMPLETE
2.1 Enrollment confirmation, program name, and curriculum
2.2 Trainer's credentials
2.3 Attendance record and receipts
2.4 Trainer's written assessment of progress
TAB 3 — BEHAVIORAL EVALUATION
3.1 Certified behaviorist's written report (Template 6)
3.2 Behaviorist's credentials
3.3 Management protocol recommended, and steps taken to implement it
TAB 4 — VETERINARY
4.1 Complete records showing no history of aggression
4.2 Sterilization certificate
4.3 Microchip registration, current
4.4 Rabies vaccination certificate, current
4.5 Letter from the treating veterinarian on handling the animal
TAB 5 — CHARACTER AND HANDLING
5.1 Groomer's signed statement — how long, how often, any concerns
5.2 Boarding or daycare facility's signed statement
5.3 Veterinary technician statements
5.4 Neighbor statements (each different, each specific)
5.5 Photographs of the animal in ordinary settings with people
TAB 6 — INSURANCE
6.1 Current liability policy or quote
6.2 Written confirmation of coverage amount
6.3 Binder if obtained
TAB 7 — THE INCIDENT
7.1 Owner's incident report (Template 1)
7.2 Witness statements (Template 2)
7.3 Photographs of the location
7.4 Evidence supporting any defense: provocation, trespass, defense
of a person, misidentification
7.5 Ordinance provisions relied on, with the text
TAB 8 — PROPOSED RESOLUTION
8.1 One page: the specific conditions the owner proposes to accept,
what has already been completed, and the designation level
requested
THREE COPIES PREPARED: [ ] hearing officer [ ] agency [ ] mine
INDEX AT THE FRONT: [ ] ALL PAGES NUMBERED: [ ]
8. Pre-hearing negotiation script
CALL TO THE ANIMAL CONTROL SUPERVISOR — before the hearing
Prepare first: have the remediation package COMPLETE. This conversation
works because of what you have already done, not what you promise.
OPENING
"My name is ______________. I'm the owner in case number ______, with
a hearing scheduled for ________. I'm not calling to argue about the
incident. I'm calling because I've already completed some things and I
want to know what resolution your office would consider."
WHAT YOU'VE DONE — list it plainly, no adjectives
"Since I received the notice I have:
- installed a ______-foot enclosure with a self-closing locking gate
and posted signage;
- had a certified behaviorist evaluate [animal], and I have her
written report;
- enrolled in a [__]-week [training program] and completed [__]
sessions;
- confirmed sterilization and current microchip registration;
- obtained a liability insurance [quote / binder] for $ ______."
THE ASK — be specific
"I'd like to know whether your office would consider [a stipulated
potentially dangerous designation / resolving this without a
designation / a designation with the conditions I've already met]."
THEN LISTEN. Write down exactly what they say.
IF THEY WANT SOMETHING MORE
"I can do that. How long do I have, and what proof do you need?"
IF THEY SAY NO
"I understand. Can you tell me what the office will be asking the
hearing officer for, so I can prepare?"
[This is a legitimate question and the answer is very useful.]
CLOSING — always
"Can I bring the package by so you can look at it before the hearing?"
"Who should I follow up with, and by when?"
AFTER THE CALL
[ ] Write down: date, time, name, title, exactly what was said
[ ] Send a short confirming email: "Thank you for speaking with me
today. As discussed, I will ______ by ______, and you will
______." Keep a copy.
[ ] If a stipulation is offered, GET IT IN WRITING and read every
condition before agreeing. Confirm what happens if a condition
later becomes impossible (e.g., insurance is non-renewed).
9. Notice of appeal
[Date] FILE WITHIN THE ORDINANCE'S DEADLINE: ____/____/______
[Court or appellate body identified in the ordinance]
[Address]
NOTICE OF APPEAL
RE: In re [animal name], case number ______________
Appellant/Owner: ______________
Decision dated: ____/____/______, received ____/____/______
Deciding body: ______________________
Notice is given that ______________ appeals the decision described
above, designating [animal] as [designation] and imposing the following
conditions: ______________________________.
GROUNDS FOR APPEAL
1. The evidence was insufficient to support the designation under
[ordinance section ______], which requires ______________________.
[State what the evidence actually showed.]
2. The decision failed to consider [provocation / trespass / defense
of a person / defense of young], which is [an element / a defense]
under section ______. [State the facts.]
3. Procedural error: [no proper notice was given / the hearing was
held outside the required period / I was denied the opportunity to
[present witnesses / cross-examine / be represented] / the file was
not provided in advance despite a timely request].
4. The conditions imposed exceed those authorized by section ______,
or are not supported by the findings.
5. The animal was misidentified. [State the basis.]
6. Other: ______________________________
RELIEF REQUESTED
[ ] Reversal of the designation
[ ] Reduction to a lesser designation
[ ] Modification of the conditions imposed, specifically ____________
[ ] Remand for a new hearing
[ ] A stay of the designation and conditions pending this appeal
STAY REQUEST
Appellant requests a stay of [the destruction order / the conditions]
pending resolution of this appeal. [State the irreparable harm.]
ATTACHED
[ ] The decision appealed from
[ ] The notice and hearing record
[ ] The ordinance sections at issue
[ ] Proof of timely filing
______________________ · [Phone] · [Address]
[Counsel, if any]
Filed and served on ____/____/______ by ______________
10. Reasonable accommodation request (assistance animal in housing)
[Date]
[Landlord / property manager / HOA board]
[Address]
RE: Request for reasonable accommodation
Resident: ______________
Unit/address: ______________________________
I am requesting a reasonable accommodation to your [no-pet policy / pet
weight limit / breed restriction / pet fee requirement] under fair
housing law.
1. I have a disability as defined by fair housing law. [You are not
required to disclose your diagnosis.]
2. I have an assistance animal that provides disability-related
assistance or emotional support. The animal is a [species, breed,
name, weight, age].
3. The accommodation I request is: permission to keep this animal in my
home, without application of [the no-pet policy / the weight or breed
restriction / pet rent, pet fees, or a pet deposit].
4. Documentation. [Where the disability and the need are not obvious:]
Enclosed is documentation from ______________, [credential], who has
knowledge of my disability and of my disability-related need for this
animal.
5. My responsibilities. I understand and agree that:
- I remain responsible for the animal's behavior;
- I remain responsible for any damage the animal causes;
- I will comply with all rules regarding noise, waste, leashing in
common areas, and vaccination and licensing requirements;
- the accommodation does not permit nuisance behavior.
6. Legal points, respectfully noted:
- Pet fees, pet rent, and pet deposits generally do not apply to an
assistance animal.
- Breed, size, and weight restrictions generally do not apply.
- An assistance animal in housing need not be a dog and need not be
individually trained.
- A denial based on a direct threat requires an individualized
assessment of THIS animal's actual conduct, not breed or
speculation.
Please respond in writing by ____/____/______. If you need additional
information, please tell me specifically what you need and I will
provide what I can.
______________________ · [Phone] · [Email] · [Unit]
---
PROVIDER DOCUMENTATION — give this structure to your provider
[Provider letterhead] [Date]
To Whom It May Concern:
______________ has been [my patient / a client of this practice] since
________. I am a [licensed credential] licensed in [state], license
number ______.
Based on my professional knowledge of [name], [he/she/they] has a
[physical / mental] impairment that substantially limits one or more
major life activities.
[Name] has a disability-related need for an assistance animal.
Specifically, the animal [provides emotional support that alleviates one
or more identified symptoms or effects of the disability / performs the
following task(s): ______________]. In my professional opinion, the
animal is necessary to afford [name] an equal opportunity to use and
enjoy the dwelling.
[Signature, printed name, credential, license number, practice address,
phone]
NOTE: this letter should NOT disclose the diagnosis, and a housing
provider generally may not require it. Online "registration,"
"certification," and vests confer nothing.
11. Veterinary records request and second opinion request
[Date]
[Veterinary practice]
[Address]
RE: Request for complete medical records
Owner: ______________
Animal: ______________ Species/breed: ______________
Dates of care: ________ to ________
I request a complete copy of the medical record for the above animal,
including:
1. All examination notes and progress notes, including handwritten
notes
2. All anesthesia records, including drugs, doses, times, and route
3. All monitoring records and flow sheets, including vital signs with
times
4. All laboratory results and the dates ordered and reported
5. All imaging and the radiologist's or reviewer's reports
6. All surgical reports
7. All medication and treatment logs
8. All consent forms I signed
9. All estimates and itemized invoices
10. All communications with me, including phone notes and messages
11. Any incident report or internal note regarding the outcome
12. Any necropsy report or laboratory submission
13. Referral records to or from any other practice
Please provide these in electronic form if available. If there is a
copying fee, please advise the amount before processing.
I am entitled to these records, and I request them within [state's
required period, or "ten business days"].
______________________ · [Phone] · [Address] · [Email]
---
REQUEST FOR SECOND OPINION REVIEW
[Date]
[Reviewing veterinarian]
RE: Request for record review — [animal name]
I am asking you to review the enclosed medical record and provide a
written opinion on the following:
1. What was the standard of care for [the procedure / the presenting
condition] in an animal of this [species, age, condition]?
2. Does the record show that the standard was met? If not, in what
specific respects does it depart?
3. Specifically:
- Was appropriate pre-procedure workup performed for an animal of
this age and condition? What is customary?
- Was monitoring appropriate and documented?
- Was the response to any complication appropriate and timely?
- Was informed consent adequate given what the record shows was
disclosed?
4. In your opinion, is there a causal relationship between any
departure and the outcome? Please state your reasoning.
5. Would a necropsy have been necessary or helpful to determine cause
of death? [If applicable and if the animal has not been cremated,
please advise immediately — this decision cannot be undone.]
ENCLOSED: complete medical record · itemized invoice · consent forms ·
my written account of the events and communications
Please advise your fee for the review and for a written report. Please
also indicate whether you would be willing to provide testimony if
required.
______________________ · [Phone] · [Email]
12. Veterinary licensing board complaint
[Date]
[State Board of Veterinary Medicine]
[Address]
RE: Complaint against ______________, DVM, license number ______
Practice: ______________________________
Complainant: ______________
I am filing a complaint concerning the care provided to my [species],
[name], on ____/____/______.
1. WHAT HAPPENED — chronological and factual
______________________________________________________________
______________________________________________________________
______________________________________________________________
2. WHAT THE RECORD SHOWS
The complete medical record is enclosed. It shows:
[ ] No pre-anesthetic laboratory work was performed, for an animal
aged ______.
[ ] Monitoring entries are absent from ________ to ________.
[ ] No intravenous access was established.
[ ] The record contains no entry for ______________________.
[ ] The record is internally inconsistent: ______________________
[ ] Other: ______________________________
3. PROFESSIONAL REVIEW
Enclosed is a written review by ______________, DVM, dated ________,
which concludes: "[quote the key sentence]."
4. COMMUNICATIONS
[What I was told, by whom, and when. Attach messages.]
5. WHAT I AM ASKING THE BOARD TO DO
Investigate whether the care met the standard required of a licensee,
and take whatever action the Board deems appropriate. I understand
the Board does not award damages.
ENCLOSED
[ ] Complete medical record
[ ] Itemized invoices
[ ] Consent forms
[ ] Second opinion / review letter
[ ] Necropsy report, if any
[ ] Correspondence with the practice
[ ] My written chronology
______________________ · [Phone] · [Address] · [Email]
NOTE: this is free, it is investigated, and it creates a permanent
record. For most owners it is the most meaningful available remedy,
because damages in court are limited by the property classification in
many states.
13. Footage and evidence preservation demand
Send the same day. Retention periods are short.
[Date] DELIVER TODAY — BY EMAIL AND HAND DELIVERY
[Facility name]
[Address]
RE: DEMAND TO PRESERVE EVIDENCE
Owner: ______________ Animal: ______________
Dates of stay/service: ________ to ________
Incident date: ____/____/______
My animal sustained injuries while in your care on ____/____/______.
I am formally demanding that you PRESERVE, and not delete, overwrite,
alter, or destroy, the following:
1. ALL VIDEO AND AUDIO RECORDINGS from every camera on the premises,
interior and exterior, for the period ________ to ________. This
includes recordings that would ordinarily be overwritten on your
retention schedule.
2. All incident reports, injury reports, and internal notes
3. All daily care logs, feeding logs, and observation records for my
animal
4. Staffing schedules and time records for the relevant period
5. The intake record and any condition notation at drop-off
6. Records of every other animal present in the same area during the
period, including any incident involving those animals
7. All communications about this incident, internal and external,
including text messages and messaging application content
8. Training records for staff on duty
9. Any veterinary care obtained by you for my animal
10. Your policies on supervision, group play, and incident response as
they existed on the date
Please confirm in writing within three business days that these
materials have been preserved, and identify your video retention period
and the date on which the relevant footage would otherwise be
overwritten.
I also request copies of items 2, 3, 5, and 9, and an opportunity to
view the video recordings.
______________________ · [Phone] · [Email] · [Address]
Delivered by: [ ] email to ____________ at ________
[ ] hand delivery, received by ____________ at ________
[ ] certified mail, tracking ____________
14. Pet purchase protection notice
[Date] SEND WITHIN THE STATUTORY PERIOD — CHECK IT: ______ days
[Seller name]
[Address]
RE: Notice under [state]'s pet purchase protection law
Animal: ______________ Purchased: ____/____/______
Purchase price: $ ____________
Litter/registration/ID: ______________
I am giving notice under [state statute, section ______] that the animal
I purchased from you is [ill / has a congenital or hereditary defect].
VETERINARY FINDING
Examined by: ______________, DVM, on ____/____/______
Diagnosis: ______________________________
The veterinarian's written certification is enclosed and states:
"[quote the operative sentence]."
In the veterinarian's opinion, the condition [was present at the time
of sale / is congenital or hereditary].
WHAT WAS REPRESENTED TO ME
[ ] You stated the animal was healthy.
[ ] You provided a health certificate dated ________.
[ ] You provided no health certificate or vaccination records.
[Note: many states REQUIRE these disclosures at sale.]
[ ] Your advertisement stated: "______________________"
[ ] You provided a written health guarantee, enclosed.
THE REMEDY I AM ELECTING
[ ] Return of the animal for a full refund of the purchase price and
associated costs
[ ] Exchange for an animal of equivalent value
[ ] I WISH TO KEEP THE ANIMAL and recover veterinary expenses incurred
in treating the condition, up to the amount permitted by statute.
Expenses to date: $ ______. Invoices enclosed.
[This third option is available under most such statutes and is
what most buyers actually want.]
Please respond in writing within [__] days. If I do not receive a
response, I will pursue [a credit card chargeback / a complaint with the
state consumer protection office / a complaint with the department of
agriculture / an action in small claims court], and I will seek any
attorney's fees and multiple damages permitted by [state] consumer
protection law.
ENCLOSED: veterinary certification · invoices · sales contract ·
advertisement · health records provided (or note of their absence) ·
proof of payment
______________________ · [Phone] · [Address] · [Email]
Sent by certified mail, tracking ____________, and by email on ________
15. Pet trust worksheet
PET TRUST — INFORMATION FOR DRAFTING
THE ANIMALS — identify specifically to prevent substitution
Name ____________ Species/breed ____________ DOB ________
MICROCHIP NUMBER: ______________ Registry: ____________
Distinguishing marks: ______________________
Name ____________ Species/breed ____________ DOB ________
MICROCHIP NUMBER: ______________ Registry: ____________
[Include a clause covering animals acquired after execution.]
CAREGIVER
Primary: ______________ Phone ____________ Address ____________
Has agreed: [ ] Date discussed: ________
Alternate: ______________ Phone ____________ Address ____________
Has agreed: [ ]
Second alternate: ______________
If no caregiver will serve: [ ] named rescue/sanctuary: ____________
(confirm they accept, and whether they require a donation)
TRUSTEE — should be a DIFFERENT person from the caregiver
Trustee: ______________ Phone ____________
Successor trustee: ______________
Duty: hold and disburse funds, and require the caregiver to account
FUNDING — be realistic; courts may reduce an excessive amount
Annual costs, estimated:
Food $ ________
Routine veterinary and vaccines $ ________
Preventatives and medications $ ________
Grooming $ ________
Boarding when the caregiver travels $ ______
Supplies and replacement items $ ________
Insurance, if any $ ________
ANNUAL TOTAL $ ________
Remaining life expectancy: ______ years
Subtotal: $ ________
End-of-life and emergency reserve: $ ________
Caregiver compensation, if any: $ ________ per ________
Trustee compensation: $ ________
TOTAL FUNDING: $ ________
Funded by: [ ] trust assets [ ] life insurance [ ] POD account
CARE INSTRUCTIONS — attach as a schedule
Veterinarian: ______________ Phone ____________
Diet, brand, amount, schedule: ______________________
Medications and doses: ______________________
Known conditions: ______________________
Temperament and triggers: ______________________
Routine, exercise, sleeping arrangements: ______________________
Do NOT: ______________________
Preferences on end-of-life care: ______________________
Whether the animals must be kept together: ______________
ENFORCEMENT
Person with standing to enforce and to demand an accounting:
______________________
Accounting frequency: ______________
Caregiver may be replaced by: ______________
REMAINDER
On the last animal's death, remaining funds pass to: ______________
IMMEDIATE-TERM PLAN — a will is not read for days or weeks
[ ] Card in wallet: "In an emergency, my animals are at [address].
Contact ______________ at ______________."
[ ] Neighbor with a key who knows the plan: ______________
[ ] Written instructions on the refrigerator
[ ] Short-term funds accessible to the caregiver: $ ______, held by
______________ / POD account number ______________
[ ] Emergency contact posted at the front and back doors
INCAPACITY
[ ] Durable power of attorney includes authority to arrange and PAY
FOR animal care — a single sentence most POAs omit
16. Emergency caregiver card and door notice
WALLET CARD — print, cut, carry
┌──────────────────────────────────────────────────────┐
│ IN AN EMERGENCY: I HAVE ANIMALS AT HOME │
│ │
│ Address: ______________________________ │
│ Animals: ____ dogs ____ cats ____ other: ______ │
│ │
│ Caregiver: ______________ ______________ │
│ Alternate: ______________ ______________ │
│ Neighbor with a key: ______________ ____________ │
│ │
│ Veterinarian: ______________ ______________ │
│ Instructions are posted on the refrigerator. │
└──────────────────────────────────────────────────────┘
DOOR NOTICE — post at the front and back doors
┌──────────────────────────────────────────────────────┐
│ ANIMALS INSIDE │
│ │
│ ____ dogs ____ cats ____ other: ______________ │
│ Names and descriptions: │
│ ______________________________________ │
│ ______________________________________ │
│ │
│ In an emergency, please contact: │
│ ______________ ______________ │
│ ______________ ______________ │
│ │
│ Updated: ________ (review every 6 months) │
└──────────────────────────────────────────────────────┘
REFRIGERATOR SHEET
Each animal: name, description, microchip number, veterinarian,
medications and doses, feeding schedule and amount, temperament
notes, where supplies are kept, where the carrier and leash are,
where the records are, and who to call.
Related documents
- Animal Law: Pet Ownership, Dangerous Dog Proceedings, and Veterinary Claims
- Handling a Pet Legal Problem
- Animal Law Checklist
- Neighbor Dispute Toolkit
- Landlord-Tenant Toolkit
Templates only, not legal advice. Adapt to your facts and, above all, to your local ordinance and state statute — this area varies enormously. Federal standards at 7 U.S.C. § 2131 and § 2143 govern dealers, exhibitors, and research facilities, not household pets.
