Small Animal Reproduction Appointment Request- Collect my Stud (for evaluation, freezing, or shipping chilled semen).

Small Animal Reproduction Appointment Request- Collect my Stud (for evaluation, freezing, or shipping chilled semen).
Owner Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Stud Information
Stud Name/Call Name*
Registered Name
Registration Number
Microchip Number
Required for export of all frozen canine semen.
Breed*
Color*
Date of Birth*

MonthDayYear
Estimate if needed.
Stud Health History
Has your stud had breed- appropriate health testing performed in accordance with OFA guidelines?*

YesNo
Has he had brucellosis testing within the last 6 months?*

Yes (We will need results at time of collection).No
Has he previously been used as an active stud dog to sire litters?*

YesNo
Has he previously been collected for artificial insemination (AI)?*

YesNo
When was his last mating or AI?

MonthDayYear
Date
What proportion of his matings/AIs resulted in pregnancy and production of pups?
What is his average litter size?
Any other comments on the history of your stud dog or history of the bitches used in these matings?
Has your dog been unwell or had any trauma in the past 12 months?*
Is your stud on medication?*

YesNo
If so what medication?
Has he had any noticeable abnormalities with his scotum?*
Any other comments regarding your dog's health?
Stud Appointment Options
Why are you scheduling an appointment for your stud?*

Breeding soundness exam and semen assessmentSemen collection for shipping chilledSemen collection for freezing
Export of Semen
In general, frozen semen is not eligible for export unless the conditions of the importing country are met prior to and at the time of collection. It is the client's responsibility to advise SPH before collection is the semen is required for export. All dogs being collected for export MUST be microchipped to meet export requirements.
Is this semen intended for export?*

YesNo
Consent Agreement
The CLIENT accepts complete responsibility for any semen which may come into the charge of SPH, and in particular, further accepts that any semen delivered to the Client or to any other person purporting to act as agent on behalf of the client from SPH rests with the client. The CLIENT acknowledges that payment for storage fees is due at the time of invoicing. IN THE EVENT that the client fails to pay amounts due and owing to SPH, the CLIENT acknowledges and agrees that SPH may choose to discard the semen without notice being given and without limitation to SPH’s right to recover the amounts due and owing from the CLIENT. All semen is stored and transported at the owner’s risk.

1. I understand that semen collected at SPH is not automatically eligible for export.
2. I verify that the dog identified above is the dog being presented for semen collection and freezing at SPH.
3. Semen storage price subject to change without prior notice
4. Insurance of semen in storage is the responsibility of the semen owner
5. I understand the limitation involved with exporting this frozen semen if I chose not to microchip the donor dog
I have read, understand, and agree to the conditions.*

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Appointment Date, Medical Records and Health Testing
Medical Records and Health Testing*

Cancelof
Appointment Date Preference*

MonthDayYear
We do not guarantee appointment availability.
Should be Empty:

Small Animal Reproduction Appointment Request- Collect my Stud (for evaluation, freezing, or shipping chilled semen).

Owner Information

Stud Information

Stud Health History

Stud Appointment Options

Export of Semen

Consent Agreement

Appointment Date, Medical Records and Health Testing