After you have been approved for a puppy and you have selected the perfect puppy, the puppy will undergo an industry-leading health examination. This health exam provided by PawFax has 20 criteria and must be signed off by a certified and licensed veterinarian. The puppy must have an A+ grade before it goes home. This protects you, the puppy buyer from receiving a puppy that is less than perfect. We strongly encourage you to complete the PawFax health exam with your local veterinarian within 72 hours of receiving your new puppy.