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Pet Emergency?

Please contact your preferred animal emergency hospital.

Veterinary Emergency Group – Cary
(984)345-3033 – Doctor available 24/7
2030 Kildaire Farm Rd
Cary, NC 27518

Online Form

PennHIP Certification Form

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PennHIP Certification Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit. For more information, visit the PennHIP website.

PennHIP Website

Client Information

Please check if the address has changed since the last PennHIP evaluation.

Choice 1

Name *

First

Last

Mailing P.O. Box/Street Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Dog Information

To ensure accuracy, we recommend including a copy of the dog’s registration papers.

Registered Name *

Call Name

Breed *

Sex *

Male
Female
Neutered
Spayed

Date of Birth (Month/Day/Year) *

Animals listed in the PennHIP open-optional database will be designated as to whether they have permanent identification.

Tattoo Number

Microchip Number

Registration Number

Sire’s Registration Number

Dam’s Registration Number

IMPORTANT: Has this dog had hip surgery? *

If yes, procedure: *

Has THIS dog had a PennHIP radiograph before? *

Yes
No
Unknown

If yes, when? *

OFA Rating (if known):

Excellent
Good
Fair
Borderline
Mild
Moderate
Severe

Age when OFA rated:

Registration Upload

Click or drag a file to this area to upload.

I understand that this information will be entered into a medical database, and the results will be employed in an ongoing scientific investigation on canine hip dysplasia. However, I am also aware that my dog’s individual statistics will be kept confidential unless I authorize their release (see below). I certify that the radiographs are of the animal described above. I am aware that the radiographs will be retained by PennHIP and not returned to me. I understand that if there are fewer than twenty dogs of my breed in the database, my dog’s ranking will be made relative to the general dog population.

Signature *

Authorization to Release My Dog’s Hip Scores: PennHIP is establishing an open-optional database to facilitate identifying and listing suitable breeding candidates. If PennHIP scoring indicates my dog to be appropriate for breeding (top 40% of the breed without degenerative joint disease), I authorize PennHIP to include my dog’s hip information in the PennHIP open-optional database, which will be made available to the public. *

Initials of Owner

Date *

Why they chose us

“We were so excited that your surgeons offer the choice of an indoor or outdoor exam. Our pet is much more relaxed and less anxious in your outdoor exam room.”

-Allison H.

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