Mare Breeding Form

1
Breeding Contract Services Scroll right to see additional informaton.
2
Additional CostsServices Not included in the Breeding Contract
3
Owner/Client Name* This field is required.
First Name
Last Name
4
Address* This field is required.
Mailing Address
Physical Address
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Primary Phone Number* This field is required.
Area Code
Phone Number
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Alternate Phone Number
Area Code
Phone Number
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Email* This field is required.
example@example.com
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Is there an agent acting on the mare owner's behalf?* This field is required.
YESNO
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Agent Name
First Name
Last Name
10
Agent Phone Number
Area Code
Phone Number
11
Agent Email
example@example.com
12
In the event of an emergency, is there a secondary contact who may authorize veterinary medical and surgical treatment?* This field is required.
YESNO
13
Secondary Contact Name
First Name
Last Name
14
Secondary Contact Phone Number
Area Code
Phone Number
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Registered Name* This field is required.
16
Barn Name* This field is required.
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Registration Number * This field is required.
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Breed * This field is required.
19
Color * This field is required.
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Mare Date of Birth * This field is required.
Date
Month
Day
Year
21
Age * This field is required.Please indicate years
22
Is this mare insured? * This field is required.
YESNO
23
Insurance Information
Insurance Agency
Phone number
Type of Insurance
Policy Number
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Preventative Care History* This field is required.Proof of vaccination from a licensed veterinarian is required prior to arrival at AEVS. If vaccination history from a licensed veterinarian cannot be provided, the mare will be vaccinated upon arrival at an additiona expense to the owner.
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Does the mare have a history of any other illness, injury, colic or lameness?* This field is required.We require disclosure of any medical conditions that could affect the management of the mare before acceptance to this breeding program. The animal will be examined and current condition documented on arrival.
YESNO
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Please list previous or known medical problems.Please include date of occurence.
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Does the mare have a history of any difficulty breeding or abortion?* This field is required.
YESNO
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Please list previous or known reproductive problems.Please include date of occurence.
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Is the mare currently receiving any treatments? * This field is required.
YESNO
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Current Medication List* This field is required.
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Which type of board will be required?* This field is required.
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Our standard hospital feed plan and schedule includes free choice quality hay and a ration balancer concentrate twice daily. How should your mare be fed? * This field is required.
Feed AEVS Standard DietFeed Custom Diet
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Forage / Hay:
Type option 1
Type option 2
Type option 3
Type option 4
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Hay Quantity:
Free Choice
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Forage / Hay:* This field is required.
Orchard Grass
Alfalfa
Owner Provided
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Does this mare receive any vitamin or mineral supplements?* This field is required.Owner must provide supplement.
YESNO
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Vitamin or mineral supplement.Please indicate type, amount and frequency.
38
Are there any other special feed instructions? * This field is required.
YESNO
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Special Feed Instructions
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Last Farrier Date* This field is required.
Date
Month
Day
Year
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Farrier/Hoof Care* This field is required.Trimming or shoeing will be performed as needed or as requested. Please note any special instructions and/or contact phone numbers for a farrier to call for specific instructions. Farrier services will be billed with the boarding fees.
Trim
Shoe Front Only
Full shoe
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Board and Care* This field is required.
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Stallion Name* This field is required.A copy of the stallion breeding contract must be provided.
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Stallion Facility
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Stallion Manager Contact* This field is required.
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Stallion Manager Phone Number * This field is required.Please indicate the phone number for semen orders.
Area Code
Phone Number
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Today's Date* This field is required.
Date
Month
Day
Year
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Contract Terms & Conditions* This field is required.Please be sure to scroll to the bottom.
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Signature of Mare Owner* This field is required. By signing below, I acknowledge and agree to comply with the terms and conditions stated above. Further, I authorize AEVS to act as temporary agent on my behalf pursuant to paragraph (11) above should the Mare, her foal and/or pregnant recipient require emergency medical or surgical treatment and I authorize the release of medical and/or financial information from AEVS to the referral clinic/hospital. IN WITNESS WHEREOF the parties have executed this contract as of the day and year set forth first above.
Clear
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Please upload Stallion/Semen Contract* This field is required.
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Please upload Mare Registration papers* This field is required.
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Please upload Mare Vaccination record
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Please upload current Mare Coggin's certificate
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Please verify that you are human* This field is required.
Should be Empty:

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