BULLDOG BREED COUNCIL HEALTH FORM

The Bulldog Breed Council Health Certificate - File Completed Form Here

PLEASE ENSURE YOU HAVE DOWNLOADED, PRINTED AND HAVE HAD A VET COMPLETE THE FORM. Then come back here to file
UPLOAD A PHOTO OF YOUR COMPLETED HEALTH FORM HERE*
All 4 corners of the document must be in view

The photo must not be blurry or unreadable (your application will be refused if we cannot clearly read this document)

Please ensure you upload the correct form

This image will be used to verify the information completed below
PLEASE UPLOAD A PHOTO OF YOUR DOG HERE*
Once your image has successfully uploaded click Next, or you can Save and come back later to complete the remainder of this form

Using the form you have just uploaded please now complete the following.

Silver and Gold certificates to be applied for seperately
Dog's Date of Birth*
This will appear on the certificate exactly as you have written it
Kennel Club number*
This will appear on the certificate exactly as you have written it
Kennel Club Name*
This will appear on the certificate exactly as you have written it
Owners Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Microchip number*
This will appear on the certificate exactly as you have written it
Sex of dog*
This will appear on the certificate exactly as you have written it
Colour of Dog*
This will appear on the certificate exactly as you have written it
OTHER*
PLEASE STATE DOG'S REGISTERED COLOUR HERE

Please declare any surgery this dog has had here*
I acknowledge that this information has in no way been tampered with or altered (we may ask to see the Vet Copy if we are unsure)*

I Acknowledge
I acknowledge that this is a true and accurate account of my dog's health on the day of the examination*

I Acknowledge
I understand that inaccurate or altered information may invalidate my certifcate*

I understand
You are now required to pay £10 by either PayPal or Credit/Debit card. This payment is non refundable in the event we are unable to issue you with a certifciate.
Submission of this form will take you through to a PayPal Screen where you will have the option of paying either by PayPal or credit/debit card. The form will NOT send if payment is unsucessful.
Please select*

Please send my certificate by email onlyPlease send my certifciate by email and post
Select Payment*
prevnext( X )
Tick Here if you only want your certificates sent by emailIncludes all 3 Certificates
£5.00 Quantity

Tick Here if you want your certificates sent by email and also postedIncludes all 3 Certificates
£15.00 Quantity

Total

£0.00
Should be Empty:

The Bulldog Breed Council Health Certificate - File Completed Form Here