Edit, Download, and Sign the PennHIP Radiograph Evaluation Application

Form

eSign

Email

Add Annotation

Share Form

How do I fill this out?

Filling out this radiograph evaluation application is essential for PennHIP. First, the veterinarian or PennHIP member must complete the radiograph information section. Then, the dog owner must complete the client and dog information section.

imageSign

How to fill out the PennHIP Radiograph Evaluation Application?

  1. 1

    Complete the radiograph information section by the PennHIP member.

  2. 2

    Fill in the client information section by the dog owner.

  3. 3

    Provide detailed information about the dog, including registration and history.

  4. 4

    Sign the authorization section if you agree to release the dog's hip scores.

  5. 5

    Submit radiographs and the completed form to the PennHIP Analysis Center.

Who needs the PennHIP Radiograph Evaluation Application?

  1. 1

    Veterinarians who need to evaluate canine hip dysplasia.

  2. 2

    Dog owners seeking PennHIP evaluation for their pets.

  3. 3

    Breeders looking to identify suitable breeding candidates.

  4. 4

    Researchers conducting studies on canine hip dysplasia.

  5. 5

    Animal hospitals and clinics submitting radiographs for evaluation.

How PrintFriendly Works

At PrintFriendly.com, you can edit, sign, share, and download the PennHIP Radiograph Evaluation Application along with hundreds of thousands of other documents. Our platform helps you seamlessly edit PDFs and other documents online. You can edit our large library of pre-existing files and upload your own documents. Managing PDFs has never been easier.

thumbnail

Edit your PennHIP Radiograph Evaluation Application online.

You can easily edit this PDF on PrintFriendly using our advanced PDF editor. Simply open the file in the editor, make any necessary changes, and save the updated document. Enjoy a seamless editing experience without leaving our platform.

signature

Add your legally-binding signature.

Signing the PDF on PrintFriendly is simple and convenient. Use our built-in signature tool to add your signature to the document. Ensure your form is complete and legally binding with just a few clicks.

InviteSigness

Share your form instantly.

Sharing the PDF on PrintFriendly is quick and easy. Use our sharing options to send the completed form via email or generate a shareable link. Collaborate effortlessly with others by sharing your documents directly from our platform.

How do I edit the PennHIP Radiograph Evaluation Application online?

You can easily edit this PDF on PrintFriendly using our advanced PDF editor. Simply open the file in the editor, make any necessary changes, and save the updated document. Enjoy a seamless editing experience without leaving our platform.

  1. 1

    Open the PDF file in PrintFriendly's editor.

  2. 2

    Use the text and form filling tools to input necessary information.

  3. 3

    Make any required changes to the existing content.

  4. 4

    Review the document for accuracy and completeness.

  5. 5

    Save and download the updated PDF.

What are the instructions for submitting this form?

Complete the form with all required information. Submit radiographs and the completed application to the PennHIP Analysis Center at 20 Valley Stream Pkwy, Suite 267, Malvern, PA 19355. For priority evaluation, include a hospital fax number. Pay the evaluation fee by check payable to U of PA - PennHIP or provide credit card information. Ensure all sections are properly filled out and signed before submission. It's recommended to keep a copy for your records.

What are the important dates for this form in 2024 and 2025?

The important dates for submission of this form in 2024 and 2025 will be provided by the PennHIP Analysis Center. Generally, there are no specific deadlines, but it's best to submit the form promptly with the radiographs.

importantDates

What is the purpose of this form?

The purpose of the PennHIP Radiograph Evaluation Application is to facilitate the assessment of canine hip dysplasia using radiographs. This detailed form helps veterinarians, dog owners, breeders, and researchers gather critical information about the dog's hip condition. By evaluating the radiographs, PennHIP aims to identify suitable breeding candidates and contribute to scientific studies on canine hip dysplasia. Completing this form accurately ensures that the dog's hip condition is thoroughly examined and provides valuable data for ongoing research. Proper submission of this form also aids in maintaining comprehensive medical records and enables early diagnosis and intervention.

formPurpose

Tell me about this form and its components and fields line-by-line.

This form contains several sections that need to be completed by different parties. Each field collects specific information to evaluate canine hip dysplasia accurately.
fields
  • 1. Radiograph Information: To be completed by the PennHIP member, includes the member number, distractor number, member name, radiograph date, patient weight, hospital case number, clinical signs, severity, duration, and drugs used for restraint.
  • 2. Client Information: To be completed by the dog owner, includes last name, first name, address, city, country, state, telephone, postal code, notification of address change.
  • 3. Dog Information: Includes the dog's registered name, call name, breed, sex, tattoo number, registered number, neutered/spayed status, sire's registration number, date of birth, microchip number, dam's registration number, hip surgery history, previous PennHIP radiograph history, OFA rating, authorization to release hip scores, owner's signature and date.

What happens if I fail to submit this form?

Failing to submit this form may result in the inability to receive an accurate evaluation of the dog's hip condition. This could lead to missed opportunities for early intervention or breeding considerations.

  • Delayed Diagnosis: Without submission, a proper diagnosis and evaluation of hip dysplasia may be delayed.
  • Breeding Issues: Potential breeding candidates may not be identified, affecting breeding plans.
  • Incomplete Medical Records: The dog's medical records will lack essential information for future reference and treatment.

How do I know when to use this form?

Use this form when evaluating a dog for hip dysplasia through PennHIP radiographs. It is also required when submitting radiographs for scientific research purposes.
fields
  • 1. Veterinary Evaluation: When a veterinarian needs to assess a dog's hip condition for potential dysplasia.
  • 2. Breeding Consideration: Breeders aiming to identify healthy breeding candidates based on hip scores.
  • 3. Scientific Research: Researchers conducting studies on canine hip dysplasia using PennHIP data.
  • 4. Radiograph Submission: Submitting radiographs to the PennHIP Analysis Center for evaluation.

Frequently Asked Questions

How do I fill out the PennHIP radiograph evaluation application?

Use PrintFriendly's PDF editor to complete all necessary sections, following the provided instructions.

Can I edit this PDF form on PrintFriendly?

Yes, you can easily edit this PDF using PrintFriendly's advanced editing tools.

How do I sign the PDF form on PrintFriendly?

Use the built-in signature tool to add your signature to the document.

How can I share the completed form with others?

Use PrintFriendly's sharing options to send the document via email or generate a shareable link.

What information is required in the radiograph evaluation application?

The form requires radiograph information, client information, and detailed information about the dog.

Can I save the edited PDF form on PrintFriendly?

Yes, you can save and download the updated PDF form after editing.

Is there a fee for submitting the PennHIP evaluation application?

Yes, there is a fee for evaluation, and an additional fee for priority evaluation.

Where do I submit the completed radiograph evaluation application?

Submit the completed form and radiographs to the PennHIP Analysis Center.

Can I include my dog's registration papers with the form?

Yes, it is recommended to include a copy of the dog's registration papers for accuracy.

What is the purpose of the PennHIP evaluation application?

The application is used to evaluate canine hip dysplasia through radiographs and contribute to scientific research.

Related Documents - PennHIP Application

https://www.printfriendly.com/thumbnails/00c3187b-714a-46e1-b838-63cb55d99033-400.webp

Preparticipation Physical Evaluation Form

The Preparticipation Physical Evaluation Form is used to assess the physical health and fitness of individuals before they participate in sports activities. It covers medical history, heart health, bone and joint health, and other relevant medical questions.

https://www.printfriendly.com/thumbnails/0044f6bb-200d-4feb-af5e-5418c7c49f5b-400.webp

Health Insurance Tax Credits Guide 2015

This document provides a comprehensive guide on health insurance and premium tax credits for the 2015 tax year. It explains the tax filing rules, eligibility criteria, and detailed instructions for claiming and reporting premium tax credits. Essential for individuals who bought health insurance through the ACA Marketplaces.

https://www.printfriendly.com/thumbnails/004d5be1-e317-4428-8e2a-abdae34e3104-400.webp

TSP-77 Partial Withdrawal Request for Separated Employees

The TSP-77 form is used by separated employees to request a partial withdrawal from their Thrift Savings Plan account. It includes instructions for completing the form, certification, and notarization requirements. The form must be filled out completely and submitted along with necessary supporting documents.

https://www.printfriendly.com/thumbnails/00130a9c-16ca-4288-b930-d1b35cfc98a5-400.webp

Ray's Food Place Donation Request Form Details

This file contains the donation request form for Ray's Food Place. Complete the general information section and follow the guidelines to submit your donation request at least 30 days in advance. The form includes fields for organization details and donation specifics.

https://www.printfriendly.com/thumbnails/0068df9b-4e3c-483a-b634-e4a14e1ac2d7-400.webp

Pastoral Ministry Evaluation Form for Board of Elders

This evaluation form is designed for the Board of Elders to assess and provide feedback on a pastor's ministry. It aims to offer affirmation and identify areas for improvement. The form covers preaching, worship leading, pastoral care, administration, and more.

https://www.printfriendly.com/thumbnails/006523dd-df32-4387-b7ec-377b657bab81-400.webp

Health Provider Screening Form for PEEHIP Healthcare

This file contains the Health Provider Screening Form for PEEHIP public education employees and spouses. It includes instructions on how to fill out the form for wellness program participation. The form collects personal, medical, and screening details to assess wellness.

https://www.printfriendly.com/thumbnails/00bd082a-fe2f-430f-9aec-8e73104dc545-400.webp

Common Law Marriage Declaration Form for FEHB Program

This form is used to declare a common law marriage for the purpose of enrolling a spouse under the Federal Employees Health Benefits (FEHB) Program. It requires personal details, marriage information, and additional documentation. Submission instructions and legal implications are included.

https://www.printfriendly.com/thumbnails/0081b68c-5987-40c0-8165-6c4e6bc8ca16-400.webp

MyPRALUENT™ Enrollment Form Instructions and Details

This document provides comprehensive instructions and details for enrolling in the MyPRALUENT™ program, including benefits, patient assistance, and clinical support. It outlines the required patient, insurance, and prescriber information, as well as the steps for treatment verification and household income documentation.

https://www.printfriendly.com/thumbnails/0018a923-2651-48d9-a13e-33e539f837c5-400.webp

Application for Certified Copy of Birth Certificate

This form is used to request a certified copy of a birth certificate from the Clerk of Court Office. It includes details about the applicant, the person named on the certificate, and requires a photo ID and the correct fee. This form is only for walk-in services.

https://www.printfriendly.com/thumbnails/00180268-d199-44a7-8663-4a56cc1c8a54-400.webp

Torrance Memorial Physician Network Forms for Patients 18+

This file contains important forms for patients 18 years and older registered with Torrance Memorial Physician Network. It includes patient registration, acknowledgment of receipt of privacy practices, and financial & assignment of benefits policy forms. Complete these forms to ensure your medical records are up-to-date and to understand your financial responsibilities.

https://www.printfriendly.com/thumbnails/009686d3-b5a9-4a32-8146-5b45159f41f6-400.webp

Vodafone Phone Unlocking Guide: Steps to Unlock Your Phone

This guide from Vodafone provides a step-by-step process to unlock your phone. Learn how to obtain your unlock code by filling out an online form. Follow the instructions to complete the unlocking process.

https://www.printfriendly.com/thumbnails/0088f689-5aa6-4002-a99c-c65d49060780-400.webp

Texas Automobile Club Agent Application Form

This file is the Texas Automobile Club Agent Application or Renewal form, which must be submitted within 30 days after hiring an agent. The form includes fields for agent identification, moral character information, and requires signature from both the agent and an authorized representative of the automobile club. Filing fees and submission instructions are also provided.