Breeding Intake Info — Conley & Koontz Equine Hospital

Breeding Intake Form

The following information is needed in order to advise you to the best of our ability in regards to breeding your mare.

Your Name

First Name

Last Name

Mare's Name

First Name

Last Name

Breed

Age

How many foals has she had?

When was her last foal born?

Has she been unsuccessfully bred in the past? If so, when?

Who has her breeding records if not with us?

Has she had a culture and/or cytology this season/results?

Live cover/cooled/frozen semen?

Date of last vaccination?