Canine Health Clinic

Canine Health Clinic @ Pinelands Dog Training, LLC Wednesday March 9th, 2016
Dr. James Clinton, DVM, DACVO
Testing will be done at: 10 Tidswell Ave. Medford, NJ 08055
(Please do not send payment to this address)
  For Directions: www.pinelandsdogtraining.com

Pre-Registration and payment required:

Owner_______________________Cell#________________Other#________________

Email___________________________________________

Name of Dog___________________ Breed____________________Age___________

If your dog is AKC registered, bring a copy of your AKC registration to refer to for your Eye Certification. 

Eye Certification_________ Heart Check_________ Microchip_________

Time Preference: Please circle, I will confirm time by 3/3/16:

Early Afternoon       Late Afternoon           Early Evening         Later Evening


Questions: Contact Susan Bintliff:  sabledogs@icloud.com  Cell: 609-410-0889

Make all checks payable to:                                        
Pinelands Dog Training, LLC

Send Form & Check To:
Susan Bintliff
286 Hapete Trail
Medford Lakes, NJ 08055

Eye Certification: 40.00_________

Cardiac Check:    30.00_________

Microchipping:     40.00_________

Check Total:__________________