Big D Canine Health Clinic
Saturday, August 25, 2012
9:00 am – 4:00 pm
Location: Pet Love
2148 Royal Lane, Suite 101
Dallas, Texas 75229
CERF CLINIC
Terri L. Baldwin, DVM, MS, DACVO
Diplomate Veterinary Ophthalmologist
Dr. Terri L. Baldwin graduated from Purdue
University Veterinary Medical School in 2000 and
then completed a one year internship in Small
Animal Medicine and Surgery at the University of
Illinois in 2001. Dr. Baldwin then performed a
Comparative Ophthalmology Residency at the
University of Illinois in 2004 and received her M.S.
in 2004 as well. She returned home to Texas in May
of 2011 and currently works as a full time
veterinary ophthalmologist in Dallas and Grapevine
at Animal Ophthalmology Clinic.
The CERF exam is a general eye exam,
which screens for genetic and non-genetic
abnormalities in dogs that are being considered for a
breeding program. The CERF exam is not a
medical examination for existing problems.
CARDIAC CLINIC
Nicole Culwell, DVM, MS, DACVIM
(Cardiology)
Dr. Culwell earned her Bachelor of Science
degree in Biology from Rensselaer Polytechnic
Institute in 1998 and her Doctor of Veterinary
Medicine degree from Cornell University in 2003.
She completed a 1-year Small Animal Medicine and
Surgery Internship at Oklahoma State University in
2004. In December 2007, she completed the 3-year
Residency and simultaneously earned a Master of
Science degree at The Ohio State University.
She was a Clinical Assistant Professor at
Oklahoma State University Center for Veterinary
Health Sciences prior to joining Veterinary
Medicine Specialists of Dallas/Fort Worth
(Grapevine, TX) full time in April 2011.
The Cardiac auscultation is a general cardiac
exam, which screens for cardiac murmurs and
abnormal sounds. Murmurs will be described and
recorded.
DNA TESTING
Exercise Induced Collapse—EIC
Centro Nuclear Myopathy—CNM
Progressive Retinal Atrophy—PRA
PRA code: BIGD812 will be active from 8/13/12-8/26/12
http://www.optigen.com/opt11_form.taf?lang=en
PRA Kit must be ordered prior to health clinic by
using the code above.
AKC CAR MICROCHIP IMPLANTATION
Please have your pet’s date of birth. You may
designate a secondary contact person, phone
number and email.
AKC CANINE GOOD CITIZEN TEST
An AKC certified CGC Evaluator will be on hand
to administer a limited number of CGC tests. The
test is open to all purebred and mixed breed dogs.
CGC is a certification program that is designated to
reward dogs who have good manners at home and
in the community. The CGC provides an excellent
foundation for all other training.
All services by appointment only. Registration deadline – August 10, 2012. Get your registration forms in early!!!
Big D HRC—Health Clinic
REGISTRATION FORM
Pet Love 2148 Royal Lane, Suite 101, Dallas, Texas 75229
Return Form by August 10, 2012
SCHEDULING
1. The Big D HRC Health Clinic is August 25, 2012
from 9:00 am-4:00 pm.
2. For scheduling information contact: Stephanie Ayers
at 469-231-9146 or via email at
stepperayers@yahoo.com
3. All other inquiries check the Big D HRC website at
www.bigdhrc.com.
4. Appointments and time preferences will be on a first
come first serve basis. Please indicate your time
preference on the registration form. We will do our
best to accommodate your request. You will be
notified of your appointment time approximately one
week prior to the event by email or phone (if email is
unavailable).
5. You may be scheduled in a time frame earlier than the
one you requested if enrollment in the selected clinic
is low. Conversely, you may be scheduled in a time
frame later than the one that you requested if
enrollment in the selected clinic is high.
6. If you register for multiple services, every effort will
be made to cluster your appointments.
7. Please arrive at the clinic 15 minutes prior to your
scheduled time.
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TERMS OF REGISTRATION
Registration closing date AUGUST 10, 2012.
ONE registration form for EACH dog.
Make checks payable to: Big D HRC
Mailing Address:
c/o Stephanie Ayers
3253 Galahad Drive, Dallas, Texas 75229
Or Email form to stepperayers@yahoo.com
There will be NO refunds after the closing date except
when clinics are canceled due to low enrollment.
My email address serves as my signature for all credit
card charges related to this Health Clinic.
TIME PREFERENCE
9:00am-10:00 am
10:30am—11:30 am
12:00 pm-1:00 pm
1:30 pm—2:30 pm
3:00 pm - 3:30 pm
Owner Name:
Street Address:
City:
State:
Zip:
Best Phone Number:
Email:
Breed:
(Please bring registration papers to clinic)
Dog’s Registered Name:
Registration Number:
Dog’s Date of Birth:
Special Comments:
SERVICE
Cost per
Dog
CERF Clinic
$30.00
Cardiac Clinic
$50.00
Total
DNA
EIC—Exercise Induced Collapse
$75.00
CNM—CentroNuclear Myoppahy
$50.00
PRA—Progressive Renal Atrophy
(code)
Kit must be ordered prior to clinic –
see page 1
(Swab collection only)
$10.00
Microchipping
(includes lifetime registration)
$30.00
Canine Good Citizen Test
$15.00
TOTAL=
Check – Made payable to: Big D HRC
MasterCard VISA
Discover American Express
Expiration Date
/
CVN Code
Name on Credit Card:
Credit Card Billing Address:
City:
State:
Zip:
Signature ____________________ Date __________
Email Address
Date
I agree to the TERMS OF REGISTRATION. My
email address serves as my signature for
emailed/faxed/scanned Credit Card charges related to this
Health Clinic..
My Documents\Big D HRC\Health Clinic\2012 Health Clinic Registration Form & Flyer.doc healthclinic