Mastiff Health Award Application


Name (including titles): _____________________________________________________

Sire: ___________________________________________________________________

Dam: __________________________________________________________________

Microchip/Tattoo #______________________                DNA # ______________________

Birth Date:  ___/___/_____ (mm/dd/yyyy)  Registration #: ___________________________

Health Certificate Information:

Bronze:

     OFA Hips:  MF-___________________   OFA Elbow: MF-EL-____________________

     CERF:  ___________________

Silver:

     Thyroid:  ___________________                OFA Heart: MF-CA-___________________

Gold:

    OFA Patella: MF-PA___________________  Cystinuria: ___________________ (date)

    vWD Factor: ____________________ %

Other: _________________________________________________________________


Owner(s): ______________________________________________________________

______________________________________________________________________

Address:_______________________________________________________________

______________________________________________________________________

City: __________________________________ State:__________ Zip Code:_________

Phone: ______________________________ Email: ____________________________

Breeder(s) _____________________________________________________________

______________________________________________________________________

Address:_______________________________________________________________

______________________________________________________________________

City: __________________________________ State:__________ Zip Code:_________

Phone: ______________________________ Email: ____________________________


Include copies (not originals) of Registration Papers, and all test results/certificates.


Mail to:
Karen Flocker
309 E Harvard Pl
Gilbert, AZ 85234
Phone: (480) 632-5240
mastiffmom@cox.net


MCOA Health Committee:
Co-Chairs:
Anna May (951) 704-6022 mastiff@iinet.com  
Jenny Zinn-Boyce (562) 425-8354 jzinnboyce@aol.com    

Members:

Jan McNamee (330) 648-9427 windfallmastiffs@hughes.net 
Dr. Bill Newman (814) 623-9377 dansdad@pennswoods.net  

Subcommittee chairs:

Cancer - Jenny Zinn-Boyce (562) 425-8354 jzinnboyce@aol.com
Cystinuria - Beth Nichols (262) 859-0347 bethmastiff2@aol.com 
Cystinuria - Lisa Edwards-Filu (845) 477-0233 darkmstf@yahoo.com
DNA - Mary DeLisa (303) 929-5529 mwhipple75@aol.com
Health Awards - Karen Flocker (480) 632-5240 mastiffmom@cox.net
Hip - Elbow Dysplasia  Tammy Sholes (828) 428-3355 nicochri@bellsouth.net
PRA - Carla Sanchez (951) 696-4169 CARLACHEZ@aol.com
Seizure Disorders - Doreen Dysert (503) 348-9347 ddysert@hughes.net

Established in 1997 by Constance Parker.