Belgian Sheepdog Club of America
Health Registry Questionnaire Instructions
The purpose of this questionnaire is to establish a data base for significant health problems in the Belgian Sheepdog. This hopefully will enable us to determine the frequency of various health problems, as well as better understand the genetic versus environmental components of these disease processes. This information should aid in the development of sound breeding practices, ultimately resulting in healthier dogs. For this endeavor to be successful, the full cooperation of Belgian breeders, and pet owners alike, is critical. The health issues included in this questionnaire were selected as being of immediate concern; potentially other areas will be identified in the future as we accumulate information.
The specific health problems currently included in this survey are:
GUIDELINES FOR PARTICIPATION IN THE BSCA HEALTH REGISTRY:
- Members, as well as non-members, may submit data for entry into the registry.
- Only breeders or owners of the individual dog being registered may submit information.
- Only BSCA members in good standing may access information from the health registry.
- Participants may request information on a maximum of three dogs/year, allowing the health registry administrator up to one month to respond.
- Information on new dogs belonging to participants, as well as updated information on dogs already in the registry, is requested.
- Yearly submission of the litter registration form is requested of participants who have bred a litter(s) in the previous year.
This questionnaire should take only a few minutes to complete!
Please fill out a separate questionnaire for each dog being registered. If more than one dog is being registered, please photocopy the 5 page form, or contact the health registry administrator (see address below) for additional forms. Information on all Belgian Sheepdogs which you have bred and/or owned, currently alive or dead, is requested. Leave no entire health problem section completely blank. Place an X next to each appropriate health category, circle where indicated, or write NA (for not applicable) where appropriate. Details about the results of breedings which produced problems are requested. Include number of affected puppies, and the name of the other parent. Continue on additional pages if needed. Please write legibly in ink.
Copies of the following documents would be appreciated (these are optional but helpful if available):
- registration certificate
- four generation pedigree
- OFA & CERF certificates
- thyroid function laboratory results
- pathology reports on tumor biopsies/excisions
- autopsy/necropsy report if applicable
Health Registry Questionnaire "Updates"
Please help us keep the information in the registry current.If your dog(s) develop new health problems subsequent to the submission of the initial health registry questionnaire, please submit the following information:
- Copy the first page of the form and the page pertaining to the new health problem.
- Print the dog's registered name and #, your name, and sign the release.
- Fill in the information requested pertaining to the new health problem.
- There is no need to submit the entire form.
Please return completed forms to:
Renee L. Artymyshyn, M.D.
114 Stanton Road
Flemington, NJ 08822