Survey - Microchip Scanner Use Questionnaire

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Question - Required - Volunteer or organization name

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Question - Required - Please fill in the date that the scanner was used.

Month

Day

Year

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Question - Required - Finder name

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Question - Required - Finder's email address

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Question - Required - Finder's phone number

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Question - Required - Address/ location found

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Question - Required - What type of animal did you scan?

Dog

Cat

Other

Question - Not Required - If you selected "other," please provide the type of animal you have scanned.

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Question - Required - Was your scan successful? Did you find a microchip?

Question - Not Required - Microchip number (if present)

Question - Not Required - Owner name and contact info if found through microchip

Question - Not Required - Brief description of animal (size, color, behavior, did they have a collar, tag or license?)

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Question - Required - Outcome

	Reunited
	Left message
	Wrong number/unable to contact
	Finder will hold and try other tips for reunification
	Brought to shelter

Question - Not Required - Please share any additional information about this case here

How did you connect with the finder/what site was the animal posted on?

(Select one of the available choices or enter a different value.)
Question - Not Required -

Question - Not Required - Time logged