MARE
INFORMATION FORM
(Please Print)
Mare Name: AMHA #:
Color:
Age:
Registered Owner(s) Name _______
Phone:
___________________________ _____________
Address
Designated Veterinarian Name and Address:
Phone:
Date due to foal: Tentative-breeding date:
Non-foaling mares: Tentative breeding date:
Maiden:
Allergic sensitivities , if yes, what:
Does mare have a history of intestinal problems or colic:
Other problems or medical history that we should be aware of:
BREEDING HISTORY
Years bred (last 3 yr. Only):
Years foaled (last 3 yr. Only):
Years aborted: Early fetal loss: , if yes, when:
Uterine
infections:
, if yes, list when, what type and treatment used:
Caslic Operation: if yes, when: Ever retained Placenta:
if yes, when:
Does mare cycle regularly: Does she show heat well:
Foaling damage or difficulty:
ADDITIONAL
FOR SEMEN TRANSPORT
Do
you have access to a stallion or gelding to tease the mare? Yes
No
Do
you understand that you should notify the breeders well in advance with the
tentative dates you are planning to need semen shipped? Yes No
Do
you understand that it is essential to call the farm on the first day of your
mare’s heat cycle to schedule for transported semen? Yes No
Do
you understand that your designated Veterinarian must practice equine
reproduction as a regular part of their practice, must be available for
palpation, cultures, other necessary procedures and must consent to schedule and
inseminate your mare for each shipment from breeders?
Yes
No
Signature
Date
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