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: ___________________________