POLISH LOWLAND SHEEPDOG CLUB OF WALES AND WEST OF ENGLAND
GENERAL HEALTH SURVEY 2013-2014
Telephone Number ( if no email address)
Name of PON _____________________________________________
& pet name_______________________________________
Date of Birth___________________________ Male /Female ___________________________________
Has your PON had any significantÂ medical condition or injury ?
Could you say if the condition has been diagnosed and treated by a Veterinarian Â or other therapist & could you give details and approximate dates?
Is your PON on any treatment now?
Could you give the details of any illnesses or injuries and treatmentÂ your PON has had since 1st January 2014
Has Â your PON have any other condition/sÂ which you havenâ€t needed to consult a VetÂ eg behaviour problems, itches,Â lumps
Could you give the dates & details of any vaccinations or worming your PON has had since 1st January 2012 and whether there were any reactions
Has your PON had any routine tests such as hip scoring, eye test? Could you give the results?
What is the predominant diet of your PON eg Complete food, Dry, Barf, Vegetarian
How active does your PON keep you eg walks, agility, good citizens.
Is there anything else you would like to add?