Are You An IHA Member (*required)
(click one)
Yes No
If not, please consider joining Here. link opens in new window.
Hedgehog Owner’s Information
Owner’s Name: (required) Owner’s Address: (required)
City:(required) State/Province:(required)
Country:(required) Postal Code: (required)
Owner’s E-mail: (required) Owner’s E-mail: (required)
(please enter again to assure accuracy)
Hedgehog’s Information
If you are reporting an illness or injury, this is the list of reportable illnesses, or injuries:
Cancer, WHS (Wobbly Hedgehog Syndrome), Stroke, FLD (Fatty Liver Disease), Major Injury, Hereditary Illness, Surgeries, Major Systemic Infection, Reproductive (breeding related) Illness or Injury.
Hedgehog’s Registered Name:
Registered Name includes Breeders Herd
Intials and Hedgehog’s IHR Number
EXAMPLE: DZM Geronimo 96955
A list of Breeders and Herd Initials can be found Here. (Link opens in new window.)
Hedgehog’s Condition: (*required)
Living, Reporting Illness/Injury
Type of Illness/Injury: (*required)
SELECT ONE
Cancer
If Cancer,
List Type and Location: (required) If not applicable please enter “NONE” Duration of Illness/Injury: (required)
If deceased, and death not caused by
illness or injury, enter “NONE”
Symptoms of Illness/Injury: (required) If deceased, and death not caused by illness or injury, enter “NONE” Treatment of Illness/Injury: (required)
If deceased, and death not caused by
illness or injury, enter “NONE”
Date of Death: (required) If not deceased, enter “NONE” Cause of Death: (required)
If not deceased, enter “NONE”
Confirmed by Necropsy?: (*required)
Yes
Please indicate any additional information that would help
facilitate the registration update in the space below.
Please make sure you have filled out as much information as
possible before submitting this form.
If any of the “required” form fields have not been completed , the submission will be discarded if a valid reason why is not determined.
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