VETERINARY EXAMINATION REPORT
I have examined the following puppy and have found it to be in the condition indicated below.

Owner’s Name ________________ Pet Name ___________________

Breed ______________________ Weight _________ Temperature  _____________

Please choose only one of the following:

_____  The pet examined is in good health:
            I do not find any problems of significance.
           Comments: ______________________________________________________________________________
                             _______________________________________________________________________________

_____  The pet examined has the following minor health problem(s).
           These do not constitute a health risk and can be easily and inexpensively resolved.
           I do not recommend that the pet be returned to seller.
           Comments: ________________________________________________________________________________
                             _________________________________________________________________________________


_____  The pet examined has the following major health or genetic problems.
           I recommend that it be returned to the seller immediately.
           Comments: _______________________________________________________________________________
                             ________________________________________________________________________________

Signed ________________________________________ DVM

Date_________________20___        Time ________________AM/PM

Please mail or fax to Peggy Dixon 2819 W. 2175 S. West Haven, Utah 84401 Fax: 801-731-9316