Medway Council Stray dog collection form

  • Stray dog reference

  • Conducted on

  • Prepared by


  • Is this report for a lost or found dog

  • Date and time dog lost or found

  • Location where dog lost or found

  • Breed

  • Sex

  • Age

  • Size

  • Ears

  • Collar

  • Peculiarities

  • Colour

  • Chip number and details

  • Loser details

  • Finder details

  • Photo of dog collected by Community Warden.

Returned to owner

Dog claimed or returned to owner.

  • Dog placed in kennels

  • Any notes relevant to placing dog in kennels

  • Dog returned to owner

  • I agree to pay all Medway Council charges on receipt of invoice. I understand that if my dog strays on any subsequent occasion it will be taken straight to the kennels and that I will be liable for all costs.

  • Dog claimed by owner

  • Signature and address of purchaser or claimant

  • Charges

  • Receipt number

  • Retained on certificate



  • I declare that I have no ownership or other interest in the dog described above, which I have handed to Medway Council as a stray dog. I believe, to the best of my knowledge, that this information is true and I understand that making a false or misleading declaration may render me liable to legal action.

  • Print full name and date.

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