Name/Kennel Name_____________________________________________________________

Dog's Name_____________________________________________________________________

DOB:________________Sex_________Color__________Reg.Number____________________

I certify that the above named dog has been examined and is found to be in good physical

health.  Eyes are clear. Dog is free of skin problems.  This dog's temperment is stable and

does not show shyness or aggression in any way. This dogs bones and joints are in correct

alignment and function properly.  This dog is found to be of breeding quality.









Date Examined_____________________Signed_______________________________________