The Irish Wolfhound Foundation

Owner Information

Name *

First Name

Last Name

Email *

Verify Email *

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Dog General Information

Study Stage *

Life Cycle Study II Entry Information

I understand that this data is for research purposes only and will be held confidential by the researchers and the employees of the Irish Wolfhound Foundation. I agree to provide annual updates to the Irish Wolfhound Foundation. I understand that health information and DNA data may be provided to researchers receiving support from the IWF.

I agree to provide a yearly update providing the following information to the IWF: whether the dog is alive or dead; whether the dog has been diagnosed with a serious disease; if dead, the date and cause of death.

I consent to have my contact information released to IWF supported researchers so they can directly contact me for more detailed information. *

Yes

No

Signature *

By checking this box you are electronically signing this form and agreeing to the study entry conditions specified above:

I agree

The IWF will provide you with acknowledgement of your entry and a unique study number.

Call Name *

Registered Name

Registration #

Study ID

leave blank if you don't know

Weight in Lbs

Date of Birth (estimate for rescues) *

(mm/dd/yyyy)

Gender *

Spay/Neuter?

Final Update Information

Please complete this section if your dog, who was entered in the LCS II study, is now deceased. Complete the health section for conditions at time of death.

Date of Death *

if you don't know the exact date, please estimate.

Cause of Death *

Was the dog euthanized?

Dog Health Information

Detail for Dog's Conditions Checked Above

Detail for Parents' Other Condition Checked Above

Dog Diet Information

Estimated Body Condition Score

For an illustrated guide to Body Condition Scores please see https://www.tuftsyourdog.com/doghealthandmedicine/is-my-dog-too-thin/

Main Diet

Select the diet type that best describes the majority of your dog's diet

Other Diet Details

Supplements

Joint Supplements

Fatty Acid Supplements

Digestive Enzymes, Probiotics or Prebiotics

Vitamin/Mineral Supplement

Antioxidants

Herbs

Other

Herb Supplement Details

Other Supplement Details

Medications

Please check any of the following which your dog is taking and provide details (brand, e.g.) in detail boxes

Medication List

Heartworm Preventative

Flea and Tick Preventative (oral or applied)

Cardiac Medication

Antibiotics

Pain Medication

Other Medication

Heartworm Preventative Details

Flea and Tick Preventative Details

Cardiac Medication Details

Antibiotics Details

Pain Medication Details

Other Medication Details

Heart Screening Registration

If you wish to register for an upcoming heart screening clinic (please note there may not be one available right now), please use one of the links on the page which is displayed after you submit this form.