Online PKD submission form for owners and breeders

RBS WorldPay

We now accept online payment by credit or debit card

When you have completed the form and pressed the Submit button you will be directed to a new page outlining various payment options

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

Please note: the list price is £28.00 (plus VAT) per sample submitted

If you wish to submit more than 5 swabs please contact us for an alternative electronic form


Your name*
Email*
Telephone*
Your address*
Vet's name
Vet's address
Vet's FAX number:
	Remember my information for the next time I submit samples? (Your browser must accept cookies for this to work)

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:

RBS WorldPay

* 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 PKD negative register.

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

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