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Old 09-08-2010, 06:53 AM
Ljilly28's Avatar
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Join Date: Jan 2008
Location: PoeticGold Farm- Falmouth, Maine; Pomfret, CT
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Maine Eye and Heart Clinic!

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***

Name:_____________________________________________ _____________

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: k9golden@maine.rr.com

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.
__________________
Jill &
Lush: GCH Harborview Sweeter Than 'Shine At PoeticGold CGC
Mystic: AM CH Tamarack Billions Of Stars Over Poeticgold CGC BPIS BPISS
Tally: Goldiva Tangled Up In Blue CD RAE TDI TT CGCA CGC
Copley; BOS Chantilly's Bright Lights Big City RN TDI CGC
Finn: Sand Dancer's Infinite Sky TDI TT CGCA CGC
Co Owned Tango: Topbrass Talk Of The Town TDI CGC
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