Questionnaire Yearling Weanling

Questionnaire Yearling Weanling

Online Sale
Please fill out the following questionnaire according to horse type. All questions should be answered.
HORSES SOLD AS YEARLINGS/WEANLINGS. Sale
Horse name
HIP #
Consignor
Is this horse a cribber?

YesNo
If male, is this a horse a: Cryptorchid? Circle (Unilateral or Bilateral)

YesNo
(Unilateral or Bilateral)

UnilateralBilateral
Has this horse been gelded?

YesNo
Has this horse shown any lameness in the past 30 days?

YesNo
Does this horse have any noticeable scars or cosmetic blemishes?

YesNo
If yes, please describe:
Does this horse have any deviation from the norm in one or more hooves?

YesNo
If yes, please describe:
Is this horse shod/wearing shoes?

YesNo
If yes, please describe:
IF YES TO ANY OF THE FOLLOWING VET REPORT MUST BE SUBMITTED IN REPOSITORY.
Has this horse had any abdominal surgeries in the last two years?

YesNo
If yes, was there any resection of an abdominal organ (partial or complete) except to repair a ruptured bladder in a newborn foal?

YesNo
Has this horse had any invasive joint surgeries?

YesNo
Does this horse have any deviation from the norm in one or more eyes?

YesNo
Has this horse had surgical intervention of the upper respitory tract?

YesNo
If yes, to any of the above, please desribe, date/surgery type/name of vet, etc.

YesNo
If yes, to any of the above, please desribe, date/surgery type/name of vet, etc.
Are there any other conditions, surgeries, or details to disclose that are not listed above, please do so here:
I, the consignor, herby accept full responsibility for the content of this form and release Heritage Place, Inc from any and all liability regaurding its veracity and accuracy.
Signature
Date

MonthDayYear
Date
Email
example@example.com
Should be Empty: