LAKC presents a Heart & Eye Clinic
at Paws & Play Dog Day Care
SUNDAY, SEPTEMBER 12, 2010
1058 North Road, North Yarmouth, ME
***CLINIC REGISTRATION FORM***
Street Address: __________________________________________________ _
City: _________________________________ State: __________ Zip: _____
Phone: ________________________ Email: ___________________________
Number of Dogs: _____ HEART Exam (Dr. John MacGregor-Cardiologist $60/dog*)
Number of dogs _____ EYE Exam (Dr. Ruth Marrion- Ophthalmologist $35/dog)
Download Cardio form Orthopedic Foundation for Animals
. CERF paperwork will be provided
Breed: __________________________Bring Your AKC Reg & Micro-chip Info. (Important)
Circle time preference: 12:00 1:00 2:00 3:00
12-15 dogs/per hour will be scheduled. Limited space, but can be extended. Arrive 15 min. ahead of exam time for eye drops and complete CERF & OFA Cardio forms.
Check Money Order
Total Heart Auscultation ____ @ $60.00 US_____________
Total Heart Echos exams ____ @ $160.00 US _____________
Total Eye (CERF) exams ____ @ $35.00 US_____________
Balance Due US_____________
Please make checks payable to: LAKC (Lewiston Auburn Kennel Club)
Mail to: Mary Dickinson Wood, Goldiva Goldens & Therapy Dogs
285 Main Street, Cumberland, ME 04021
(207) 829-3700 (home) Email: firstname.lastname@example.org
There will be no refunds for cancellations!
*** NOTE: If an echocardiogram is necessary, Dr. MacGregor will do the exam immediately afterwards. An additional fee of $160.00 will be charged for the use of the ultrasound equipment. Please bring cash or check to be prepared for this contingency. IF you know your dog needs an echo, you can save $60 by scheduling ahead of exam time for a total of $160 instead of $220. For our friends from Canada, due to a problem cashing checks drawn from Canadian banks, please bring US dollars to cover the cost of any follow-up exams. Thank you.
BISS GCHB CH Tamarack Billions Of Stars Over Poeticgold CD RN TDI CGCA CGCU CGC BPIS Top 20 2015 "Mystic"
Goldiva Raleigh Tangled Up In Blue CD RAE TDI TT CGCA CGC "Tally"
GCH CH Harborview Sweeter Than 'Shine At PoeticGold CGC "Lush"
AM CH Pebwin Reverie SoothSayer CGC "Sayer"
PoeticGold I Named A Star For You CGC "Cambridge"
RainyDay PoeticGold Secret Society " Hiphop"
in memory of "Finn" Sand Dancer's Infinite Sky TDI TT CGCA CGC ( 10/29/2002-11/26/2015)