DV HIPS CERTIFICATION

 

 
 

The American Dobermann Association preserves the Dobermann breed as protection, family companion, and working dog, according to FCI Standard

Send application & payment to: ADA - Po Box 2231 - Snohomish, WA 98291 -USA.
Please make money order or cashier's check in US funds, payable to ADA

Dog's Name Female Male

Registration Nr. WT / DOB Tattoo Nr. Color

Sire Reg. Nr.

Dam Reg. Nr.

Breeder Country

First Name Last Name ADA Member Nr.

Address Phone

Vetrinary Clinic:

Clinic Name Phone Appointment Date

With form & fee, please send the followings:
Copy of official registration Copy of official 3-generation pedigree

Owner Statement: I, the undersigned, agree to abide by By-laws, rules, and regulation of American Dobermann Association (ADA). I shall do my best to uphold its purpose of promoting and preserving the natural talents of the Dobermann breed as protection, family companion, and working dog, according to the FCI Standard. I shall use the hips certification with integrity. All entries made in this application are true and correct.

Signature: _________________________________________ Date: ___ / ___ / ___

For ADA Office Use Only: Date Received: __ /__ /__ Amount: ____ Check # _____

Sent DV-HD Form to Owner - Date: Sent to Germany - Date:
Received X-Rays DV-HD Form from Owner -Date: Received reading from Germany - Date:
Sent official results to owner - Date: HD1 HD2 HD3 HD4 HD5