Online HCM submission form for owners and breeders

Fields marked * must be completed. Please ensure the information is entered correctly since it forms part of the final HCM certificate that will be sent back to you.

If you are submitting more than 5 swabs please enter the first 5 and press Submit, then follow the on-screen instructions.

You must tick the declaration box at the bottom of this page before submitting the form.

Please include a cheque for £28.20 (inc VAT) per sample submitted.


*Your name:**
*Email:**
*Telephone:**
*Your address:**
Vet's name:
Vet's address:
Vet's FAX number:
Promotional code:
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Cat 1 registered name*	Colour	Registration No.	DOB (dd/mm/yy)

Microchip No.	Sex	Breed*

Cat 2 registered name	Colour	Registration No.	DOB (dd/mm/yy)

Microchip No.	Sex	Breed

Cat 3 registered name	Colour	Registration No.	DOB (dd/mm/yy)

Microchip No.	Sex	Breed

Cat 4 registered name	Colour	Registration No.	DOB (dd/mm/yy)

Microchip No.	Sex	Breed

Cat 5 registered name	Colour	Registration No.	DOB (dd/mm/yy)

Microchip No.	Sex	Breed

Comments:

* I declare that the sample(s) presented for testing is/are from the cat(s) described above, and that the particulars provided are correct. I agree that the results may be used anonymously for statistical and research purposes, which may be published. I understand that samples submitted in this way will not be eligible for entry onto the FAB HCM negative register.

Please note: when you press the Submit button you will be directed to a new page containing your details. You must print the new page, sign and date it and include it with your swabs.

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