Epilepsy reporting form
The AHT is recommending we sequence the genome of an HWV who has idiopathic epilepsy for the give a dog a genome project. We now need to find suitable dogs from whom the AHT can select who they would like samples from.

The following questions will enable us to ensure your your dog fulfills the guidelines set out by the AHT for suitable dogs for this purpose. Should your dog meet their initial requirements we will send you out further details.

We really need as many submissions as possible to ensure the best chance of finding the ideal dog to sequence. We are grateful to anyone who can help us with this important research into this devastating disease. Your answers will not be publicised.

Email address *
Your name *
Your answer
Dog's pedigree name *
This is required by the AHT since they need the pedigree of the dog that will be sequenced.
Your answer
Date of birth
MM
/
DD
/
YYYY
Sire's name
Your answer
Dam's name
Your answer
Has your dog been diagnosed with idiopathic epilepsy? *
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