Firechaser’s Cockers

“PROOF OF VET EXAM”

This form must be signed by your veterinarian within 3 business days and returned to me – to be kept on file.

Puppy Name: AKC#

Date Purchased / / @ $

D.O.B. / / Color: Male / Female

Sire: AKC#

Dam: AKC#

New Owners:

I the attending licensed veterinarian, have

examined the above Cocker puppy on the date of , and found the puppy to be in

condition.

Any additional comments:

Veterinarian Info:

Name/Clinic:

Address/City/State/Zip/Phone#

******SIGN AND RETURN ONE COPY TO******

FIRECHASER COCKERS

12150 PENDARVIS LANE

WALKER, LA 70785

PHONE 225-665-4315