FROZEN SEMEN SHIPMENT REQUEST

Doylestown Animal Medical Clinic Reproduction

802 North Easton Road

Doylestown PA, 18902

267-885-4808

repro@damcvets.com
FROZEN SEMEN SHIPMENT REQUEST

This form is to be completed by the female's owner BEFORE the semen will be shipped.
We do not ship our tanks to residential addresses
Please contact us as soon as the female begins her heat cycle so we have adequate time to prepare your shipment. We do not accommodate same-day or next-day shipment requests.

Early notification allows us to properly schedule and support multiple clients. Urgent same-week shipment requests may be accommodated when possible and will be subject to an additional fee.

All forms must be completed in full before the semen will be released.

Shipping fees are usually paid by the female owner.
The semen owner is ultimately responsible for all charges if the Credit Card number used is declined.
Please check one of the following
Please check one of the following*

I have confirmed that my veterinarian has storage facilities for frozen semen. Ship at your convenience.My veterinarian does not store semen, but the female is in heat and will be used for a breeding.This form is for future breeding arrangements. Please store semen until I notify you.
TODAYS DATE:*

MonthDayYear
Date
ESTIMATED DATE OF BREEDING:*

MonthDayYear
Date
OWNERS NAME (STUD):*
STUD'S REGISTERED NAME:*
Breed*
AKC #*
Call name:*
OWNERS NAME (FEMALE):*
FEMALE'S REGISTERED NAME:*
Breed*
AKC #*
Call name:*
SHIPPING TO:
Hospital/Clinic:*
Dr. Name:*
ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE:*
ZIP CODE:*
Any shipping restrictions?*
SEND INVOICE TO:
Name:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:*
Email Address:*
example@example.com

Doylestown Animal Medical Clinic Reproduction

802 North Easton Road

Doylestown PA, 18902

267-885-4808

repro@damcvets.com
FROZEN SEMEN CREDIT CARD AUTHORIZATION FORM
I understand that the charge of $515.00 is for the frozen semen shipment service which
includes the preparation, packaging, and the initial tank rental.
I have provided the following completed forms
- Semen Disposition (signed and sent by the owner of the semen)
- Frozen Semen Shipment Form
FedEx Shipping Fee is Not Included
The FedEx shipping fee is determined by the destination zip code.
Shipments are sent as Priority Overnight.
In the case of International shipments and those going to Hawaii, you will need to go
through a third party shipper.
I agree to pay $50.00 for every day the tank is not returned after the 7^th business day. In the event the tank is not returned within 30 days or if it is returned damaged, I understand that my credit card will be charged a $1500.00 replacement fee.

We provide a Return FedEx Label and we ask that the tank is shipped back to Doylestown Animal Medical Clinic the day you recieve it, or the following day. Please avoid weekend delivery.
By signing below, I am authorizing Doylestown Animal Medical Clinic to charge my credit card for Domestic Frozen Semen Shipment service and the FedEx fees associated.

Doylestown Animal Medical Clinic Reproduction

802 North Easton Road

Doylestown PA, 18902

267-885-4808

repro@damcvets.com
Semen Release of Liability
Frozen Semen
I, fully understand that Doylestown Animal Medical Clinic cannot be held responsible or liable for any delays in shipment due to time delays with Federal Express, any customs or government office, any airline if shipping other than FedEx or the services of any hired brokerage service or agent. All semen delivery dates are estimates which have been provided to Doylestown Animal Medical Clinic by these agencies.
Occasionally there are weather/flight delays, paperwork, processing delays or the requirement of additional paperwork for customs clearance releases. I have been advised that extended time delays (past 5 days) or errors on the part of the customs agents may cause semen damage or destruction. I understand these are beyond the control of Doylestown Animal Medical Clinic and not the financial responsibility of Doylestown Animal Medical Clinic. Doylestown Animal Medical Clinic agrees to promptly provide any necessary paperwork to the shipping company (i.e.: Fed Ex) or a customs office in the event it is needed or required to expedite the clearance release and delivery.
This shipment will be insured by Doylestown Animal Medical Clinic to cover ONLY the shipping tank replacement in the event of damage/loss during shipping.

We do not insure the semen itself.
Additional insurance will be the sole responsibility of the semen owner to cover the value of the semen.
I agree to hold Doylestown Animal Medical Clinic and employees of Doylestown Animal Medical Clinic harmless in the event that these delays occur or damange to semen. I am releasing Doylestown Animal Medical Clinic of any liability due to these circumstances.
By my signature below, I am declaring I have read and agree with the above
Signature:*

Clear
Printed Name:*
Date:*

MonthDayYear
Date
Should be Empty:

FROZEN SEMEN SHIPMENT REQUEST

We do not ship our tanks to residential addresses

Please check one of the following

SHIPPING TO:

SEND INVOICE TO:

FROZEN SEMEN CREDIT CARD AUTHORIZATION FORM

FedEx Shipping Fee is Not Included

Semen Release of Liability

Frozen Semen