NOTIFICATION OF ILLNESS FORM -ONLINE Please enable JavaScript in your browser to complete this form.Name *FirstLastDog's NameDog's KC Registered Name if KnownAge of DogMale/Female/NeuteredDog's Sire (Father)Dog's Dam (Mother)DiagnosisDate of DiagnosisTreatment if anyVets NameWould you be happy for me to contact you for more information about the condition?YesNoIf you are OK, please provide your contact details either phone or email or bothWould you mind if I contacted your vet to ask any follow up questions? This is unlikely, and would not be done wothout notifying you firstYesNoAny other comments?Email *Submit