Alpharetta Animal Hospital-Hips and Elbows Dysplasia

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Examining veterinarian’s name or veterinary hospital

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I hereby request the OFA to provide a hip and/or elbow evaluation of the animal described on this application. I certify that the image submitted is of this animal and that neither the pelvic nor the elbow conformation have been surgically altered. I understand that the image submitted will be retained by the OFA, understand that the image is submitted for a consensus evaluation based on the independent, professional judgment of consulting board-certified veterinary radiologists, and I hereby release the OFA from any and all liability resulting from the consensus evaluation. I understand the OFA will release all normal hip and/or elbow results for animals over 24 months to the public, and by submitting this application I agree the OFA may do so. Normal hip results are defined as consensus evaluations of Excellent, Good, or Fair, and normal elbow results are defined as consensus evaluations of Normal. Abnormal hip and/or elbow results (including Borderline results) will not be released to the public unless the initials of a registered owner appear in the authorization box below. Results for animals under 24 months will only be released and published if all the criteria described on page 2 of this application have been met. By submitting this hip and/or elbow application I agree to the associated current OFA evaluation fees and understand that no results will be released or reported until all related charges are paid in full.

Signature of owner or authorized representative