Pregnancy Confirmation Certificate
Examination Details
- Date of examination
- Time of examination
Owner's Details
- First name
- Last name
- Address
- Phone
Animal's Details
- Name
- DOB (age)
- Microchip
- Weight (kg)
- Species
- Breed
- Colour
- Markings
Pregnancy Assessment
- Method of assessment
- Outcome
- Date of mating
- Estimated stage of gestation
- Estimated due date
- Estimated number of offspring
- Findings / comments
Estimates of gestational stage, due date and number of offspring are estimates only. Offspring counts, in particular, are unreliable on ultrasound and are best assessed by radiographs in late gestation. A pregnancy not detected at an early examination does not exclude pregnancy; recheck as advised by the veterinarian.
Veterinary Certification
I, the undersigned veterinary practitioner, examined the animal described above on the date shown, using the method of assessment recorded, and certify that the outcome and findings recorded on this certificate are true and accurate at the time of examination.
- Veterinarian name
- Registration number
- Practice name and address
- Phone
- Date signed
Veterinarian signature
Clinic stamp
