Dog Health Certificate Information
Please take the time to fill out as much information as possible.
* Required
Rescue Name
*
Your answer
Dog Name
*
Your answer
Birth Date
Please provide your best estimate if this is not known.
MM
/
DD
/
YYYY
Sex
Male
Female
Breed
If known - if not best guess
Your answer
Coloring
Please check the predominant color
Black
Blue Merle
Brindle
Brown / Chocolate
Golden
Silver / Gray
Tan
Tri color
White
Other:
Weight
Last weigh in.
Your answer
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