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Submission

 
 White Shepherd Genetics Project
Health Clearance Submission Form

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You may only submit data for:

a)    Dogs that you own     and/or     

b)    Pups parented by a dog that you own

* Required Fields

 

 

 

Your Information

Your Full Name:*

Full Address:*

Email(s): *

Phone(s):*

 

Dog's Information 

Registered (Co)Owner of Dog :  *                                                          

Registered Name of Dog: *

Date of Birth of Dog:*

 

Gender:

Call Name:

Registration/Perm ID:

 

Sire's Details 

Registered Name of Sire:

Sire's Call Name:

Registration/Perm ID:

 

Dam's Details

Registered Name of Dam:

Dam's Call Name:

Registration/Pern ID:

OFA, PennHIP, OVC or other hip eval

 

 

Hip Eval Date:

Age of Dog When Eval:

OFA, OVC or other form of elbow eval


Elbow Eval Date:

Age of Dog When Eval:

Please list any other health clearances

Clearance Date:

Age of Dog When Cert:

Please add important comments. Use a separate sheet if necessary:

 

 
 White Shepherd Genetics Project
Health Clearance Submission Form
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  White Shepherd Genetics Project
Health Clearance Submission Form
"