WHF Health Clinic Registration

2008 WHF Health Clinic Registration

This form is for pre-registering for the health clinics to be held at the 2008 AWC National Specialty.
Please note that you will still need to mail your check after filling out the form.
We are not able to accept credit cards at this time.

Enter your information here then click the "Submit" button to send your registration.

My Information
Name:
Address:
City, State Zip:
Phone:
Email:
Registration Information

# of Dogs for CERF Testing:

@ $25 each =

BAER Testing (use one line only)

# of Dogs for BAER Testing - results released to WHF Database:

@ $25 each =

# of Dogs for BAER Testing - results remain confidential:

@ $45 each =

Cardiac Echocardiogram exam (check one box only, limited to one dog per owner)

Echocardiogram - results released to WHF Database:

@ $100 each =

Echocardiogram - results remain confidential:

@ $175 each =

Select preferred day to have the cardiac test done:

Wednesday, April 23rd

Thursday, April 24th

# of Dogs for AKC DNA cheek swab test:

@ $30 each =

Myostatin Deficiency DNA test (use one line only)

# of Dogs for Myostatin Deficiency test - results released to WHF Database:

@ $28 each =

# of Dogs for Myostatin Deficiency test - results remain confidential:

@ $48 each =

Total amount of check due:

$ 0.00

Additional Comments:

Please makes checks payable to Whippet Health Foundation (or WHF) and mail to:
Dr. Lisa Costello
14855 Newark Rd.
Newark, IL 60541

Please direct any questions or comments about this form to Lisa Costello at mtncow@earthlink.net.