CAUSE OF DEATH REPORT

 

The death of your Glen of Imaal Terrier is a very sad moment, and we appreciate that it may be difficult to face this task, but for the benefit of the breed as a whole it would be very helpful if you could spare a few minutes to fill in this form.

 

All information is treated in the strictest confidence, and will only be released with the written permission of the owner.

 

 

Name of Dog:

 

Date of Birth:                                                               Date of Death:

 

Cause of death:

(Copies of any veterinary reports are especially valuable)

 

 

 

 

Any serious health issues during life:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name and address of owner/breeder:

 

 

 

 

 

Please return completed form to Jean Rogers

Hedge Green Cottage, Blackjack Road, Swineshead, Boston, Lincs. PE20 3HH

 

or email jean@e-f-g.co.uk