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How do I fill this out?
Filling out this radiograph evaluation application is essential for PennHIP. First, the veterinarian or PennHIP member must complete the radiograph information section. Then, the dog owner must complete the client and dog information section.
How to fill out the PennHIP Radiograph Evaluation Application?
1
Complete the radiograph information section by the PennHIP member.
2
Fill in the client information section by the dog owner.
3
Provide detailed information about the dog, including registration and history.
4
Sign the authorization section if you agree to release the dog's hip scores.
5
Submit radiographs and the completed form to the PennHIP Analysis Center.
Who needs the PennHIP Radiograph Evaluation Application?
1
Veterinarians who need to evaluate canine hip dysplasia.
2
Dog owners seeking PennHIP evaluation for their pets.
3
Breeders looking to identify suitable breeding candidates.
4
Researchers conducting studies on canine hip dysplasia.
5
Animal hospitals and clinics submitting radiographs for evaluation.
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What are the instructions for submitting this form?
Complete the form with all required information. Submit radiographs and the completed application to the PennHIP Analysis Center at 20 Valley Stream Pkwy, Suite 267, Malvern, PA 19355. For priority evaluation, include a hospital fax number. Pay the evaluation fee by check payable to U of PA - PennHIP or provide credit card information. Ensure all sections are properly filled out and signed before submission. It's recommended to keep a copy for your records.
What are the important dates for this form in 2024 and 2025?
The important dates for submission of this form in 2024 and 2025 will be provided by the PennHIP Analysis Center. Generally, there are no specific deadlines, but it's best to submit the form promptly with the radiographs.
What is the purpose of this form?
The purpose of the PennHIP Radiograph Evaluation Application is to facilitate the assessment of canine hip dysplasia using radiographs. This detailed form helps veterinarians, dog owners, breeders, and researchers gather critical information about the dog's hip condition. By evaluating the radiographs, PennHIP aims to identify suitable breeding candidates and contribute to scientific studies on canine hip dysplasia. Completing this form accurately ensures that the dog's hip condition is thoroughly examined and provides valuable data for ongoing research. Proper submission of this form also aids in maintaining comprehensive medical records and enables early diagnosis and intervention.
Tell me about this form and its components and fields line-by-line.
- 1. Radiograph Information: To be completed by the PennHIP member, includes the member number, distractor number, member name, radiograph date, patient weight, hospital case number, clinical signs, severity, duration, and drugs used for restraint.
- 2. Client Information: To be completed by the dog owner, includes last name, first name, address, city, country, state, telephone, postal code, notification of address change.
- 3. Dog Information: Includes the dog's registered name, call name, breed, sex, tattoo number, registered number, neutered/spayed status, sire's registration number, date of birth, microchip number, dam's registration number, hip surgery history, previous PennHIP radiograph history, OFA rating, authorization to release hip scores, owner's signature and date.
What happens if I fail to submit this form?
Failing to submit this form may result in the inability to receive an accurate evaluation of the dog's hip condition. This could lead to missed opportunities for early intervention or breeding considerations.
- Delayed Diagnosis: Without submission, a proper diagnosis and evaluation of hip dysplasia may be delayed.
- Breeding Issues: Potential breeding candidates may not be identified, affecting breeding plans.
- Incomplete Medical Records: The dog's medical records will lack essential information for future reference and treatment.
How do I know when to use this form?
- 1. Veterinary Evaluation: When a veterinarian needs to assess a dog's hip condition for potential dysplasia.
- 2. Breeding Consideration: Breeders aiming to identify healthy breeding candidates based on hip scores.
- 3. Scientific Research: Researchers conducting studies on canine hip dysplasia using PennHIP data.
- 4. Radiograph Submission: Submitting radiographs to the PennHIP Analysis Center for evaluation.
Frequently Asked Questions
How do I fill out the PennHIP radiograph evaluation application?
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What information is required in the radiograph evaluation application?
The form requires radiograph information, client information, and detailed information about the dog.
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Yes, you can save and download the updated PDF form after editing.
Is there a fee for submitting the PennHIP evaluation application?
Yes, there is a fee for evaluation, and an additional fee for priority evaluation.
Where do I submit the completed radiograph evaluation application?
Submit the completed form and radiographs to the PennHIP Analysis Center.
Can I include my dog's registration papers with the form?
Yes, it is recommended to include a copy of the dog's registration papers for accuracy.
What is the purpose of the PennHIP evaluation application?
The application is used to evaluate canine hip dysplasia through radiographs and contribute to scientific research.
