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The Drive For 2,000 DNA Samples

Thank you for choosing to participate in the Canine Hereditary Cancer Consortium's (CHCC) drive toward 2,000 samples. We are hopeful these samples will enable the CHCC to take advantage of new genetic resources and technologies to develop genetic screens, diagnostic tests, and treatments for hereditary canine cancers as well as gain insight into the biology of human disease.

If your dog has been diagnosed with cancer, please donate a one-time DNA sample and help the CHCC reach its goal of 2000 samples.

Simply complete the form below and you will receive a follow-up e-mail with instructions for your veterinarian on how to collect and submit a sample. We will request either a blood or mouth swab sample a priori.

NOTE ABOUT COST: The CHCC covers the cost of shipping and processing samples, and can reimburse the cost of a blood draw up to $10, though most vets will provide the sample free of charge if they are informed that it is for academic research.

Confidentiality
All owner information and medical records of your pet's blood and/or tissue samples will be kept confidential. No information by which your pet can be identified will be released or published without your written authorization.

Pet Information

Dog's Name:

Breed:

Year of Birth (approximate if unknown):

Sex:
Male Female Neutered Male Spayed Female

Has your dog been diagnosed with cancer by a veterinarian or specialist?
Yes No

If yes, what type of cancer?
Hemangiosarcoma Osteosarcoma Lymphoma Malignant histiocytosis Melanoma Uncertain Other (please specify)

Other (type of cancer):

Owner Information

Owner's First name:

Owner's Last name:

Address:

City:

State:

Zip:

Phone: (include area code, e.g. (000)000-0000

E-mail:

Confirm e-mail:

What is this? reCAPTCHA is a CAPTCHA service that helps to digitize books, newspapers and old time radio shows. A CAPTCHA is a program that can generate and grade tests that humans can pass but current computer programs cannot. For example, humans can read distorted text as the one shown below, but current computer programs can't. This prevents abuse from "bots," or automated programs usually written to generate spam.




Questions?
For questions, please call 616-234-5569 or email CHCC@vai.org.










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