I am a graduate veterinarian currently licensed to practice in this state.

I examined the mare on this date and found her to be in sound breeding condition. There is no indication that she would be unable to conceive or carry a foal to term. She has current Coggins Test and has received normal immunizations and worming for pregnant mares. I enclose the results of a uterine culture report showing that the mare to be free infection.

____________________________________         __________________________________
Signature                                                                   Date

________________________________________________________________________
Veterinarian’s Name, Address & Telephone

Instructions:
1. This report must be received before semen shipment.
2. The uterine culture must be taken in estrus, within the past 60 days, and submitted to a recognized laboratory.

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INSEMINATION REPORT

____________________________     ______________________________
Mare Owner                                                        Mare
                                                         ______________________________________
                                                                            Reg. #

I am a graduate veterinarian currently licensed to practice in this state. I inseminated the mare on this date at________________________AM/PM.

____________________________________     ___________________________________
Signature                                                               Date

_________________________________________________________________________
Veterinarian’s Name, Address, & Telephone

Instructions:
1. This report must be received within 10 days of insemination.
2. Any unusual circumstances related to insemination should be described on the back of this report.

I am a graduate veterinarian currently licensed to practice in this state.
I examined the mare on this date and determined that she (is) (is not) pregnant.

____________________________________         __________________________________
Signature                                                                   Date

________________________________________________________________________
Veterinarian’s Name, Address & Telephone

Instructions:
1. The mare must be examined between 55 and 65 days after insemination.
2. This report must be received by NORSIRE within 10 days of examination.
3. The results of the examination should be described on the back of this report.
4. This report is not required if a Loss of Pregnancy Report has been received.

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LOSS OF PREGNANCY REPORT

____________________________     ______________________________
Mare Owner                                                        Mare
                                                         ______________________________________
                                                                            Reg. #

I am a graduate veterinarian currently licensed to practice in this state.
I examined the mare listed above on this date and determined that she failed to settle, aborted, or delivered a foal which failed to stand and suck.
I believe the mare received reasonable care during pregnancy, including normal immunizations and worming for pregnant mares.

____________________________________         __________________________________
Signature                                                                   Date

________________________________________________________________________
Veterinarian’s Name, Address & Telephone

Instructions:
1. This report must be received within 10 days after the loss of pregnancy is discovered.
2. The circumstances of the loss of pregnancy should be described on the back of this report.