Mare Breeding Passport

The following online form may be completed in place of the Mare Breeding Passport included in the semen shipment provided to the mare owner.

We rely on this information to provide accurate conception rates for mare owners and to generate Breeding Certificates for the registration of foals. Prior to submitting this form please ensure you have selected the appropriate contract format purchased by the mare owner, incomplete or inaccurate forms will not be accepted by our office as a replacement of the Mare Breeding Passport.

Breeder’s Name:

Breeder’s Email:

Mare Name:

Stallion Name:

Please indicate if you received (choose one):

Cooled semenPer dose frozen semenFreshened frozenFrozen semen with a 1-year agreement

Per Dose Frozen:

The undersigned Veterinarian or authorized Breeding Manager, certify the following:

That at the following times and on the following days, I artificially inseminated the mare identified above with the semen of the stallion identified above.
I personally verified the name of the stallion and lot number on the straws of frozen semen.
This semen was bought on a per dose basis; any remaining straws of frozen semen are the property of the mare owner.

For Cooled:

I, the undersigned Veterinarian or authorized Breeding Manager, certify the following:

That at the following times and on the following days, I artificially inseminated the mare identified above with the semen of the stallion identified above.
I personally verified the name of the stallion on the cooled semen paperwork or on the name and lot number on the straws of frozen semen.
No other mare was inseminated with the semen designated for the above mare.
Any excess cooled semen was promptly and properly destroyed.

For Freshened Frozen:

I, the undersigned Veterinarian or authorized Breeding Manager, certify the following:

That at the following times and on the following days, I artificially inseminated the mare identified above with the semen of the stallion identified above.
I personally verified the name of the stallion on the freshened frozen semen paperwork provided.
No other mare was inseminated with the semen designated for the above mare.
Any excess cooled semen was promptly and properly destroyed.

For frozen semen with 1 year:

I, the undersigned Veterinarian or authorized Breeding Manager, certify the following:

That at the following times and on the following days, I artificially inseminated the mare identified above with the semen of the stallion identified above.
I personally verified the name of the stallion and lot number on the straws of frozen semen.
No other mare was bred with the semen and that an inventory of (number) straws remains in either:

in a storage tank under my supervision

OR

the liquid nitrogen transportation tank returned to SBS.

OR

No semen remains from this breeding
Remaining frozen semen purchased remains the property of Hilltop Farm.
Hilltop Farm will coordinate with the Veterinarian or Breeding Manager regarding the return of remaining semen.

Insemination Date

Pregnancy Check Date

Pregnancy Check Result

Additional notes from the veterinarian

Name of the vet/electronic signature

Date

By typing my name here and entering todays's date, I, as the undersigned Veterinarian or authorized Breeding Manager, signify that I have read the agreement above, certify the information to be true/correct and agree to the terms and conditions.

Mare Breeding Passport

Thank you