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Over 30 Years of Experience ** No Phone line needed **

(303) 423-3429

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Full Name*

Address Line 1* (include Street, City, State and Zip Code)

Home Phone*

Cell Phone

Email*

Name of Bitch and Breed*

What litter is this for her?*

Has she had prior problems whelping if she has had prior litters?*

Breeding Dates:(please also include progesterone levels for breeding and Breeding dates and ultrasound results)

Are you planning to do an ultrasound, or if you have already done one how many puppies did they see?*

How does the internet get to the location of the whelping? Cable or Satelite? Do you have a landline?

What dog food or diet are you feeding?

Are you using any suppliments?

Veternary Name, Address and Phone number

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9111 W 38th Ave, Wheat Ridge, CO 80033 

Phone: (303) 423-3429 & (888) 281-4867

Email: wlpwise@aol.com

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