Form for Visiting Mares

Mare’s name: Stallion 2011:
Sire:
Dam:
Status: Barren   In Foal
Maiden   Foal at foot
Year of Birth:
Colour: In Foal to:
Passport No: Last Service Date:
Date of last: EVA
CEM
COGGINS
EHV1.4
Has this mare:
1
been stitched?
Yes No
permission to stitch if necessary?
Yes No
2
produced a jaundice foal?
Yes No
3
slipped foal?
Yes No
4
ever has Virus Abortion?
Yes No
5
been on a stud affected by Virus Abortion?
Yes No
6
any peculiarities in temperament? (E.g. difficult foaling, foaling with no warning, hard to catch, kicks, silent heat…)
7
been insured?
Yes No
if so name of the insurance company:
Is the Foal:
1
to be blood typed on the farm?
Yes No
2
insured
Yes No
if so name of the insurance company:
OWNERS NAME:
ADDRESS:
Tel: Mob:
Fax: Email:
Accounts Address if different (give
% of ownership if applicable):
Name
Address
Tel: Mob:
Fax: Email:
Special Instructions
Every care will be taken with your mare / foal but no responsibility whatever is accepted for any accident, disease, injury or death to your mare and/ot foal while visiting the stud.
Agree Disagree
Every care will be taken with your mare / foal but no responsibility whatever is accepted for any accident, disease, injury or death to your mare and/ot foal while visiting the stud.

Signed: Owner /Agent__________________________
Name ________________ Date__________________