Border Collie CL DNA Test Report Submission Form

By filling out this form and pressing the "submit" button at the bottom of this page, you are agreeing to make this information public and have it published on this website.

Registered Name:

Owner's Name:

Country of Residence:

Registration Number:

Sire:

Dam:

Date Of Birth (Month/Day/Year):

Gender:

Male

Female

OptiGen Accessment # or Lab # (Please note - You MUST include this number in order to be listed in the database. - Example of # : 05-1234, 06-1234, BRC 1234, CB 123):

Results:

Normal/Clear

Carrier

Affected

Email Address: (Please note - You MUST include your email address for verification of this submission.) :