Pennhip application form 2026

1. Click ‘Get Form’ to open the pennhip application form in the editor.
2. Begin by selecting your payment method. Choose between Regular Evaluation Fee or Priority Evaluation, and indicate if you will pay via check or credit card.
3. Fill in the required Hospital Fax number if opting for Priority Evaluation. Ensure all details are accurate to avoid delays.
4. Complete the Radiograph Information section with your PennHIP member number, distractor number, date of radiograph, member name, patient weight, and hospital case number if applicable.
5. Provide clinical signs and severity ratings as needed. List any drugs used for restraint in the designated area.
6. The dog owner must print their information clearly. Include last name, first name, address, city, state, country (if outside the U.S.A.), telephone number, and postal code.
7. Fill out dog information including registered name, call name, sex, breed, registration numbers, and any previous hip surgeries or evaluations.
8. Review all entries for accuracy before signing at the bottom of the form to certify that all information is correct.

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