SCWT Database Submission Form

Owner Name

First

Last

Breeders Name

First

Last

Please try and find the name of the breeder in your records. You can always update this at a later date by emailing comments@scwtdb.org -

Co-Owner Name if applicable.

First

Last

Email

Dogs Call Name

Date of Birth

If you happen to have a file on your dog we would very much appreciate your giving us as much information as possible.

Registered Name if known

Registration Number if known

Name of Sire from pedigree if available

Please make every attempt to locate the sire and dam.

Name of Dam from pedigree if available

Sex of Dog

Where did you purchase this Wheaten:

Are you the Breeder or the Owner

Health Section

Tell us about your dogs health condition(s) if none state so.

If your dog has had cancer please give us as much information as possible. Such as oral, mammary gland, heart etc. There are over 100 different types of cancer listed in the database and we have to categorize the type of cancer your dog has. Thank you.

Are vet records available on this dog? Note that submitting vet records aides researchers. The more information we have the more useful we can be to the breed and dogs everywhere. Diagnosis will be marked Anecdotal if no records are available.

Yes - I will email them to comments@scwtdb.org
No - they are not available any longer
I do not wish to submit vet records.

*Please consider submitting vet records as this is important for research and to help other animals with the same health issues. Vets will print out a diagnosis sheet for you to submit.

If the dog is deceseasd do you know what age they died or date?

Date of death or age of death

If deceased what was the cause of death (old age euthanasia is a cause of death)

Did your dog have the PLN Variant Gene Test or other DNA testing?

Yes and I will send it
Yes and I unable to send it
No

You can obtain DNA testing on your dog from Wisdom Panel, Optimal Selection, Embark, or a University Lab such as PennGen. There are labs in other countries, please contact health@scwtca.org to obtain that information.

Other Information

Upload Records or Photos here

Drag & Drop Files, Choose Files to Upload

Comments:

By clicking the Submit Data button you are stating that the above data is correct and accurate to the best of your knowledge and that You voluntarily submit the above data for entry into the SCWT Database. you authorize release of this data in accordance with the database policies on the www.scwtdb.org website. You understand that disease, health. or temperament conditions that were diagnosed after after placement of a dog is verified by the current owner before being entered into the database.

Yes

Address - If you are out of the country and prefer to just add your address to the comment section that will also work.

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

We would love to have photos of your Wheaten for our database. You can submit up to four photos. Email them to comments@scwtdb.org

Is this an update to a dog already in the database?

Yes
No
Not sure

Signature

Clear Signature

SCWTCA Endowment: www.scwtcaendowment.org

SCWTCA Website:
www.scwtca.org

Visit the database at www.scwtdb.org

Questions? Email comments@scwtdb.org

Thank you for participating and supporting Wheaten Health!