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Breed Bias Incident Report

Have you and your dog been the victim of breed discrimination? If so, report it here. This reporting tool will help document incidents of breed bias to help educate the public about breed discrimination.

If the breed - or even the perceived breed - of your dog has led to incidents of discimination, including verbal or physical assaults, or even violent attacks in public or private, you are the vicitim of breed discrimination. Examples include:

* Being denied access to parks or other public areas, simply because of the breed of your dog.

* Retail stores demanding that disabled persons with service dogs leave due to the breed of dog.

*Restaurants demanding that disabled persons with service or therapy dogs leave due to the breed of dog.

*Hospitals, nursing homes of other facilities that discriminate against therapy dogs, excluding them based on breed.

*Airlines that deny service to the disabled .due to the breed of dog

*Hotels, Motels and Campgrounds denying accomodations to dog owners of certain breeds of dogs.

* Being denied housing in places that allow dogs because of the breed of dog that you own.

* People making rude comments to you or about you and your dog within earshot.

* People or organizations that deliberately exclude you and your dog from participating in an activity or event due to the breed of your dog.

* If you and or your dog have been verbally assaulted, screamed at or cursed at due to the breed of your dog.

* If you and your dog have have experienced a physical attack - you've been spat upon, kicked at, or have had objects thrown at you, because of the breed of your dog.

These are just some examples of personal incidents of breed discrimination. By sharing your experience, you can help create change by helping to educate the public about thisimportant issue.

Thank you for your support.

Today's Date * DD / MM / YYYY
What is the date the article or story was published?
Your Name *
Your Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Your Phone Number

Please include Area Code. For numbers outside the US or Canada, please include Country Code.
Your Email Address
Your Dog's Name *

If Unknown, please write the words "Unknown" into the fields.
My Dog:
Is A Family Pet Has Completed Obedience Training Is A Therapy Dog Is A Service Dog Is A Show Dog Is A Performance Dog Is A Search & Rescue Dog A Trained Working Dog Other
My Dog Is A: *
American Pit Bull Terrier American Staffordshire Terrier Bull Terrier Staffordshire Bull Terrier Rottweiler Akita Doberman Pinscher Chow Chow German Shepherd Mastiff Mixed Breed Dog Other Breed (Please List Below)
If Other, List Breed Here:
Date Of Breed Bias Incident DD / MM / YYYY
Approximate Time Of Breed Bias Incident HH : MM : SS AM/PM
What Kind Of Breed Bias Incident Occured?
Denied Access To Public Park Denied Access To Dog Park Rude Comments From Strangers Verbal Assault - Screamed At Or Cursed At Physical Assault - Spit At, Kicked, Objects Thrown At You Or Dog Asked To Leave Pet-Friendly Restaurant or Cafe Asked To Leave Retail Store w/Service or Therapy Dog Denied Accomodations At Hotel or Motel Denied Accomodations At Campground Denied Service By Airline Excluded From Therapy Dog Program By School, Hospital or Nursing Home Denied Access To Public Event Denied Participation In Activity Other
Name Of Place Where Breed Bias Incident Occured *

If Unknown, please write the words "Unknown" into the fields.
Address Where Breed Bias Incident Occured
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please Describe What Happened To You Or Your Dog:
Web Address Of Entity Involved In Breed Bias Incident
Did You File A Formal Complaint With The Company Or Organization?
Yes No
Name Of Company/Entity Representative First Last
If Unknown, please write the words "Unknown" into the fields.
Phone Number of Company/Entity Representative

Please include Area Code. For numbers outside the US or Canada, please include Country Code.
Email Address Of Company/Entity Representative
If So, What Response Did you Receive?

Please tell us why you think there is a bias in this story.
Were You Or You Dog Physcially Attacked, Hurt or Injured In This Incident? *
Yes No
If So, Did You Or Your Dog Require Medical Attention Due To This Incident?
Yes No
Did You File A Police Report?
Yes No
What Is Your Occupation? *
Gender
Male Female
Age
Under 18 18 - 24 25 - 34 35 - 45 45 - 54 55 - 64 Over 65
Race Or Ethnicity
White Black/African American Hispanic or Latino Asian Native American Other
Do You Belong To A Dog Club Or Dog-Related Organization? *
Yes No
If So, Please List Orgs
Have You Contacted Your Local Or State Representative Concerning This Issue?
Yes No
Do You Have Any Comments You Would Like To Share About Your Dog And Breed Discrimination?
Future Communications
Yes, I would like to receive email updates Yes, I would like to volunteer to track breed discrimination in my area No, please don't contact me
Do You Have A Website?
Please Tell Us About Yourself

Do you own animals? If so - please share here? Which breeds or species? Do you belong to any clubs or organizations? Thanks!
Thank You

Thank you for helping to track breed discrimination. Your submissions will help educate local and state legislators and the public about breed discrimination, and help make sure that dogs and their owners are judged according to deed and not breed.
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Thank You