Breeding Clearance Certificate
Examination Details
- Date of examination
- Time of examination
Animal's Details
- Name
- DOB (age)
- Microchip
- Weight (kg)
- Gender
- Desexed
- Species
- Breed
- Colour
- Markings
Animal's Health
- General comments about animal's health
Breeding Details
- Age at time of veterinary check
- Number of litters with live offspring
- Purpose for offspring
- Date of last whelping / queening
- Is this the first oestrus cycle?
- All vaccinations and parasite treatments up to date?
Genetic Disorders
- Known and/or notable genetic disorders / predispositions
Veterinary Practitioner & Breeder Details
- Veterinary practitioner name
- Contact phone number
- Practice name and address
- Breeding business / member name
- Registration prefix / proprietor
- Domestic animal business / state membership number
Declaration
I, the undersigned veterinary practitioner, in my professional opinion and in consultation with the owner, believe this animal to be in good health, with no obvious signs of physical, behavioural, or genetic disorder, and to be suitable to be bred for the purpose stated above on the date of examination.
- Veterinary practitioner name
- Date signed
Veterinary practitioner signature
Clinic stamp
