Skip to main content

Contact Us

About Us
- Contact Us
- Explore OVC
Our Hospitals
Client Information
- Contact Us
- Your Veterinary Care Team
Referring Veterinarian Information
Clinical Trials
Make A Donation
News

search

Blood Donor Program Application Form

First Name
Last Name
Address
City
Province
Postal Code
Home Phone
Mobile Phone
Work Phone
Email
How did you hear about the OVC HSC Blood Bank?
Dog's Name
Breed
Nature of the dog
Date of Birth
Male/Female
Spayed/Neutered
Weight (min. 55 lbs.)
Travel history outside of Canada
Who is your regular Veterinarian?
When did your dog last have annual vaccines (dates)?
Rabies vaccine (date)
Is your dog on any medications? If so, please list them.
Has your dog had any previous surgeries? If yes, was any excessive bleeding or bruising noted?
Does your dog have any medical conditions at present? (Skin, heart, respiratory, gastrointestinal, hormonal, etc.) Please list any previous medical history.
Has your dog ever been sedated before or had a general anesthesia? If yes, were there any problems?
What diet does your dog eat? Canned, kibble or cooked?
Is your dog on heartworm prevention?
- Yes
- No
Is your dog on tick prevention?
- Yes
- No
Has your dog ever received a blood product?
- Yes
- No
Does your dog have any skin problems?
- Yes
- No
Does your dog have a history of seizures?
- Yes
- No
Has your dog ever been used as a breeding dog?
- Yes
- No
Does your dog have any allergies (food or environmental)?
- Yes
- No
Does your dog receive routine dental cleaning?
- Yes
- No
Any history of bleeding problems?
- Yes
- No
Comments on any of the questions asked.

Δ

© 2024 OVC Health Sciences Centre.
Powered by LifeLearn Veterinary Websites

About Us
- Contact Us
- Explore OVC
Our Hospitals
Client Information
- Contact Us
- Your Veterinary Care Team
Referring Veterinarian Information
Clinical Trials
Make A Donation
News