Certification Clinic Registration Form

April 17 – 18 – 19, 2020

Graham Animal Hospital, 98A Trafalgar Road, HILLSBURGH, ON N0B1Z0

Please Do Not Call the Vet Clinic directly
For information email  jmaydan@sympatico.ca

Please complete all of the information in the form below. Information submitted in prior years was not carried forward from prior years. You will not be allowed to submit your form unless the required fields are completed. Required fields are marked with an asterisk (*) beside the field name. Enter n/a for fields that do not apply to your dog.

Be sure to check off your preferred day(s) in the boxes provided. Space is limited so appointments will be taken on a first come, first served basis until all available spaces are filled. Your appointment will be scheduled to match your selection as closely as possible; however, exact times cannot be guaranteed.

IMPORTANT: All procedures except Eye Exams will be offered on Friday, April 17, 2020.

IMPORTANT: THE CLOSING DATE FOR SUBMITTING AN APPLICATION FOR THE CLINIC IS APRIL 1, 2020.

IMPORTANT: Clients will be billed a $50 fee per dog for any ‘no-shows’ or cancellations with less than 48 hrs. notice.

PRICES: For information about prices for any of the screening tests, please download the current CLICK HERE FOR PROCEDURE PRICE SCHEDULE

OTHER INFORMATION:
Opthalmologist: Dr. Charlotte Keller
Cardiologist: Dr. Aaron Wey.

NOTE: SOME MAP PROGRAMS SHOW TRAFALGAR ROAD AS MAIN ST THROUGH HILLSBURGH.

Certification Clinic Data Form

Form to collect data for the certification clinic
  • Select Preferred Day For Appointment

  • Choose Procedures

  • Dog’s Information

  • Date Format: MM slash DD slash YYYY
  • Owner Information