Female Canine Breeding Check-In Form

Please bring your pet’s registration paperwork to your appointment or upload it to this form.

Owner's Name(Required)

First Last

Phone(Required)

Email(Required)

Please double-check spelling

Address

Street Address Address Line 2 City State ZIP Code

How did you hear about us?

Breed/Color/Distinguishing Marks:

Date of Birth:

Registration Number:

Female "Call" Name:

Registered Name:

Microchip Number:

Tattoos:

Stud "Call" Name:

Registered Name:

Source of Semen:

Incision type:

Flank

Midline

Feeding instructions (type, amount, frequency):

Current medications and dosage:

Vaccination Status:

Facility:

Brucellosis Test Date

Results

Heartworm Test Date

Results

Personal items left with dog:

Personal habits - food aggressive, fence climber, protective, etc.:

Breeding history:

Registry Information File Upload

Max. file size: 8 MB.

When arriving at the clinic be sure your pet is leashed, whether in the clinic or yard. This is for their safety as well as your own.

CAPTCHA

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Pricing Changes

Due to our increasing costs, we have been forced to raise some of our prices.

We will now be adding a $50 handling fee to all semen retrieval shipments and all incoming semen shipments.

Semen storage will be going up from $10 per vial straw to $15 per vial/straw.

Thank you for your continued support and understanding.