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MARE
Mare Name & Registration No: _______________________________________ Age:__________ Breed:___________________
Maiden Mare? Yes ____No ____ Foal at Side? Yes____ No ____ # Previous Foals _______________________
List All Current Vaccinations/Dates:_______________________________________________________________________________
Dental Care Up to Date? Yes ___ No____ Body Condition Score:____ Date of Recent Deworming:_____________________
Hoof Care (Shoes?):__________________________ Early Breeding Light Program Details: _____________________________
Stall: Yes ____ No ____ Outdoor Paddock: Yes____ No____ Pasture: Yes____ No ____
Date of Last Oestrus Cycle: ______________________________ Confirmed by: Ultrasound Teasing Other
Hormone Therapy Details:______________________________________________________________________________________
Veterinary Exam/Pre-Breeding Information: _______________________________________________________________________
Details:______________________________________________________________________________________________________
Foaling History including any difficulties: _________________________________________________________________________
Special Medication:____________________________________________________________________________________________
Feed Routine & Details:________________________________________________________________________________________
Mare Vices/Habits: ____________________________________________________________________________________________
STALLION
Stallion Name & Registration No: _______________________________________ Age: ________ Breed:___________________
Cooled/Frozen Semen: Yes ____ No ____ Hand Breeding/Live Cover: Yes ____ No ____
Veterinary Exam/Pre-Breeding Information: _______________________________________________________________________
Breeding Farm Contact Information:______________________________________________________________________________
______________________________________________________________________________________________________________
Collection/Shipping or Breeding Schedule:________________________________________________________________________
Special Instructions/Contract Specifications:_______________________________________________________________________
____________________________________________________________________________________________________________
OWNER
Owner Emergency Contact Information:____________________________________________________________________________
Address:________________________________________________________________________________________________________
Veterinary Emergency Contact Information:_________________________________________________________________________
AUTHORIZED SIGNATURES
Mare Owner Signature & Date:________________________________________________ Date:______________________________
Veterinary/Breeding Facility Signature: ____________________________________________ Date:___________________________
MARE
Mare Name & Registration No: _______________________________________ Age:__________ Breed:___________________
Maiden Mare? Yes ____No ____ Foal at Side? Yes____ No ____ # Previous Foals _______________________
List All Current Vaccinations/Dates:_______________________________________________________________________________
Dental Care Up to Date? Yes ___ No____ Body Condition Score:____ Date of Recent Deworming:_____________________
Hoof Care (Shoes?):__________________________ Early Breeding Light Program Details: _____________________________
Stall: Yes ____ No ____ Outdoor Paddock: Yes____ No____ Pasture: Yes____ No ____
Date of Last Oestrus Cycle: ______________________________ Confirmed by: Ultrasound Teasing Other
Hormone Therapy Details:______________________________________________________________________________________
Veterinary Exam/Pre-Breeding Information: _______________________________________________________________________
Details:______________________________________________________________________________________________________
Foaling History including any difficulties: _________________________________________________________________________
Special Medication:____________________________________________________________________________________________
Feed Routine & Details:_______________________________________________________________________________________
Mare Vices/Habits: ____________________________________________________________________________________________
STALLION
Stallion Name & Registration No: _______________________________________ Age: ________ Breed:___________________
Cooled/Frozen Semen: Yes ____ No ____ Hand Breeding/Live Cover: Yes ____ No ____
Veterinary Exam/Pre-Breeding Information: _______________________________________________________________________
Breeding Farm Contact Information:______________________________________________________________________________
______________________________________________________________________________________________________________
Collection/Shipping or Breeding Schedule:________________________________________________________________________
Special Instructions/Contract Specifications:_______________________________________________________________________
______________________________________________________________________________________________________________
OWNER
Owner Emergency Contact Information:____________________________________________________________________________
Address:________________________________________________________________________________________________________
Veterinary Emergency Contact Information:_________________________________________________________________________
AUTHORIZED SIGNATURES
Mare Owner Signature & Date:________________________________________________ Date:______________________________
Veterinary/Breeding Facility Signature: ____________________________________________ Date:___________________________