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Health Screening Registration Without Screening Donation (No Payment)

You may use this form to schedule IWF health screening without making a donation to help us pay for the cost of testing your dogs. 

You will be contacted with your scheduled time, and if we need additional information.

If you have any questions, please email Frances Abrams at or call her at 937-371-3609.

Owner Contact Information
Please note all contact information is required.

First Name
Last Name



Address Line 1
Address Line 2
ZIP/Postal Code

cell phone preferred so we can contact you at the event site
Testing Information
Please indicate which show or event you are scheduling screening for.
This show has multiple testing days for heart screening. Please select your preferred day.
We will try to accommodate your preference in scheduling.
Please fill out one set of questions for each dog to be tested.