Mare Health Form

Please turn in at your convenience, but before needing a shipment. Thank you! 

Mare Name_______________________________ Breed_________________________

Registration Number______________________ Age_______________________

Owner's Name___________________________________________________________

Owner's Address__________________________________________________________________________

Owner's Phone_________________________________________________

Is Mare Currently in Foal?_______________________________ Date Due______________________

Maiden Mare?_____________________________________

Did your vet do a uterine Culture?
Results_________________________________________Date_______________

Current Uterine Cytology and/or Biopsy Results, if done (most recent date, attach copy of pathology report)___________________________________________________________________________________________

Any prior retained placenta?___________________________Any prior caslick?_________________________

Any prior abortion?_____________________________________Any prior fetal loss?_______________________

Any past uterine infections?_______________________________________________________________________

Foaling Damage or Difficulty?_____________________________________________________________________

Does Mare cycle regularly?______________________________Does mare show heat well?_______________

Last three breeding years__________________________________________________________________________

Last three foaling years____________________________________________________________________________

_____________________________
signature, Mare Owner or Agent

Please mail to: Magpie Farm, 1151 Cook Rd, Yakima, Wa 98908 ••• or you can send along with your breeding contract