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Dog Genetics Research sample donation

Instructions for the owner

  1. Print this PDF document
  2. Make an appointment with your vet or qualified person who is allowed to take a blood sample

  3. Consent declaration:

I agree that the data and the sample material of the above- mentioned animal may be used for scientific research projects. The data and leftover sample material will become property of the University of Bern.

City, Date: ______________________________________  Signature: _______________________

  • Send the sample in a jiffy bag at room temperature together with this document to:

Institute of Genetics
University of Bern
Bremgartenstrasse 109a
CH-3001 Bern

  • Declaration for international shipments

- content: HS-Code 0511.99.85
- exempt animal specimen for research, non-infectious
- UID/EORI DE4444 0643 7447 453
- VAT-No. University of Bern CHE-115.250.351
- value 1 €, 1 £ or 1 $

Instructions for the vet/qualified person taking the blood

- 5 ml EDTA blood (min 2 ml)
- labeled with the registration of the dog:
- Date of sampling/Entnahmedatum:

 

ÖHZB/WH 1921

Send sample at ambient temperature together with this document.

Instructions for the lab

Complete the data in the appropriate file.


Breed:


Enter the following details:
- Name of the dog:
- Registration number:
- Date of sample: see above
- Date of receipt:
- Entered by:
- leave all other fields blank


The blood sample is then aliquoted and frozen at -20°C.

Whippet

Whippet

ÖHZB/WH 1921

Folgende Angaben registrieren

Probe in die entsprechende Datei eintragen.


Rasse:


Folgende Angaben registrieren:
- Name des Hundes:
- Zuchtbuchnummer:
- Entnahmedatum: siehe oben
- Eingangsdatum:
- eingetragen von:
- alle anderen Felder leer lassen


Anschliessend die Blutprobe aliquotieren und bei -20°C
einfrieren.

Whippet

Don Luis de Lobito Azul

ÖHZB/WH 1921

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