Missouri Department of Agriculture

Animal Health Complaint Submittal

Please DO NOT include any personal, confidential, and/or sensitive information in your responses on this form (e.g. social security number, credit card information, health information, account number, etc.).
Complainant Information
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Subject of Complaint
Provide the full name and address of the person/business against whom you are filing this complaint.
Last Name*
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Zip code*
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Primary Phone
Phone 1
Phone 2
Phone 3
Details of Complaint
Please state your complaint briefly and clearly, noting specific violations of the law.

Species

Please provide as much information as possible.*

Witness
Provide full names and addresses of any other persons/witnesses who can verify the facts alleged.
 
Zip code
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Primary Phone
Upload
Attach copies of documents (bills, correspondence, pictures, etc.) that would substantiate your complaint.

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