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HEALTH QUESTIONNAIRE
TO HELP IN THE CREATION OF GENETIC PEDIGREES AND THE COMPILATION OF HEALTH HISTORY REPORT. REPORT FOR THE USE OF ALL BUA ACCREDITED British UTONAGAN BREEDERS

The British Utonagan Association would like you to get involved in our current health studies, this will enable us to provide breeders with the tools required to further the future of the British Utonagan, and help us work at clearing all genetic faults and will promote positive and well researched breeding programs, enabling us to keep good dogs and lines that have started producing a true type in the breeding program by breeding against defective genes that have been found in the breed. We intend to develop genetic pedigrees available to all genuine breeders in an open health registry, this is common practise in most pedigree dogs and is the best way forward to further the future of the British Utonagan.

Please note that we are gathering information on defective genes, not defective dogs.

The information gathered will be available to our breeders and genuine enquirers through BUA on a password protected area on our web site, users of the open health registry will have to sign a contract of use before a password will be allocated to them.
All Microchip numbers, DNA profiles and addresses will be withheld from the publics view for security reasons.

Thank you for your participation.

Full Registered Name of Dog/Bitch
Registered Name of Dam
Registered Name of Sire
Date of Birth Select Date
Microchip Number
Hip/Elbow Score Yes
No
Hip/Elbow Results
BVA Eye Screen Yes
No
Eye Screen Results
Von Willebrands Tested Yes
No
Von Willebrands Results
Does your Dog/Bitch suffer Epilepsy Yes
No
If yes: What date was the first seizure? Select Date
Type of Seizure
Does your dog/bitch suffer from any heart condition? Yes
No
If Yes: Please give details
Does your dog/bitch have an incorrect bite? Yes
No
If Yes: Please give details
Has your dog/bitch ever had any skin condition? Yes
No
If Yes: Please give details
What do you feed your dog/bitch?
Are there any other medical problems you have encountered with your dog?
Your Full Name *
Address *
Postcode
E-mail Address: *
Telephone *

* Required Contact form by myContactForm.com

Thank you for your participation in our study, your help is very much appreciated

THE BRITISH UTONAGAN ASSOCIATION

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