Beta Tester Sample Intake Information Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone (###) ### #### Canine Information Canine Name Breed Age Sex Male Female Weight (lbs) Spayed/Neutered Yes No Diet & Lifestyle Information Current Diet Brand and Type of Food Supplements Given (If any) Medications Currently Taken Known Allergies or Sensitivities Water Source Tap, Filtered, Bottled, Well, etc. Activity Level Low Moderate High Any Recent Health Concerns or Diagnoses THANK YOU We will email you a sample submission form, sampling instructions, and shipping label to the email provided. Thank you again for helping us to develop this product! Thank you!You will receive an email with sampling instructions, a sample submission form, and a pre-paid shipping label in the next few days.Your sample is going to be used to help dial in our instrumentation and methodology. Once completed, you will receive a detailed lab report with results and recommendations via email.
