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Health Clinic Submission Form

Please fill out and submit the information below to list a clinic on the OFA's clinic calendar and receive discount labels for applications.

Date of Clinic:

Name of Sponsoring Organization/Club:

Location, including city, state, zip:

Clinic Time(s):

All Breed Clinic?

If Single or Selected breeds, list:

List Tests below (one per line; test: physician, cost):

Is Pre-registration required?

If yes, list pre-registration date:

Details and contact information for those wanting to register for the clnic:

Approximate number of dogs expected at the clinic:

Number of discount labels requested:

Your name (name of person submitting clinic:

Your email address:

Snail Mail Address to send labels to (name, street address, city, state, zip):

                

 

 

 

Partners

Canine Health Information Center (CHIC)

Canine Health Foundation

Canine Eye Registry Foundation (CERF)

Morris Animal Foundation

Animal Health Trust

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