Health Questionnaire

Introduction
Owner Information
Dog Information
Skin
Ears
Eyes
Heart
Musculoskeletal
Endocrine
Gastrointestinal
Immune-mediated Disease
Cancer
Other
Behavioral Problems
Notes

Introduction

The Health Survey is being conducted by the CSPCA Health Through Education Committee. So if you have a Shar-Pei please take a moment and take our online health survey. Or you can also download the survey in a PDF format which you can fill out when you have time and drop it in the mail.
Thank you.

Health Survey Form

Instructions

Please fill out one questionnaire per dog. If your dog has none of the problems outlined in this questionnaire please still submit the questionnaire.
It is preferable to fill out the survey based on a veterinary medical diagnosis. This will ensure consistency and accuracy.