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:                                                                                                           

Does she show false heat:                              Date of last uterine culture:                                  

 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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