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Full Name*

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

Cell Phone*

Home Phone*

Email*

Name of Bitch and Breed*

Veterinarian Name, Address and Phone number*

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 supplements?*

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

What litter is this for her?*

Thank you!

We have received your submission. We will be in contact with you within 48 hours.

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

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