Appointments and Payment Can Be Made by Regular Mail Or Email
Presents their Annual All-Breed Eye and Heart Clinic / Saturday MAY 6TH, 2017
Clinic to be held at
2887 184 Street, Surrey B.C.
***NOTE NEW DATE***
SAS Heart Screening performed by: Dr. Marco Margiocco DVM.
Diplomate, American College of Veterinary Internal Medicine,
Specialty of Cardiology / GRCBC members $ 50.00
Non members $ 65.00
OFA Eye exam performed by Marnie FordBSc,
PhD, DVM, DACVO / GRCBC members $40.00
Non members $45.00
APPOINTMENTS AND PAYMENT CAN BE MADE BY REGULAR MAIL OR EMAIL
IF EMAILED – SEND
IF REGULAR MAIL: Christine Kobler, 5434 Chinook St, Chilliwack V2R 0A6
Pre-registration and pre-payment is required. PLEASE register early. Space is limited. Cheques must be made payable to the GRCBC.
We need a minimum of FIFTY heart appts for the clinic to run, so please book asap.
those people who are wanting BOTH eye and heart appointments will be booked in the morning UNTIL THE MORNING FILLS.
THOSE PEOPLE WHO ARE WANTING JUST EYE APPOINTMENTS WILL BE BOOKED IN THE REMAINING TIME SLOTS SO ONLY AFTERNOON APPOINTMENTS MAY BE AVAILABLE. I WON’T KNOW UNTIL I GET ALL THE HEART APPOINTMENTS SCHEDULED. I WILL DO MY BEST TO ACCOMMODATE EVERYONE.
please have your forms in by april 22nd, 2017.
For information call or text: CHRISTINE KOBLER 604-703-4003
Please use the correct form – see next 2 pages
PLEASE USE THIS FORM IF YOU ARE EMAILING IT IN WITH PAYMENT
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DOES THIS DOG NEED EYESHEART BOTH(please circle one)
DOG’S REG’D NAME
BREED and SEX
TATTOO OR MICROCHIP NO.
REGISTRATION NUMBER
DATE OF BIRTH MONTH/DAY/YEAR
OWNER’S NAME(S)
STREET ADDRESS
CITY PROVINCE POSTAL CODE
DOG’S CALL NAME
REFUNDS WILL BE GIVEN (less any email fees) FOR CANCELLATIONS
UP TO APRIL 15th, 2017
AFTER APRIL15th, NO REFUNDS – NO REFUNDS FOR NO SHOWS
Those who tender NSF cheques will be responsible for any bank fees which shall be paid prior to the clinic.
PLEASE USE THIS FORM IF YOU ARE SENDING IT BY REGULAR MAIL
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DOES THIS DOG NEED EYESHEART BOTH(please circle one)
Dog’s registered Name
Breed
Sex / Tattoo
Microchip # if applicable
Dog’s Registration No.
CKC or AKC (please circle)
DOB: (eg Jan 1, 2012)
Please write out in full DO NOT put 12/09/08
Owner’s Name
Phone No.
Address
City
Postal Code
Email Address
Dog’s call Name
See prior page for cancellation rules
PLEASE PRINT VERY CLEARLY