Great American InsuranceStallion Breeding Soundness Exam |
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| Stallion Name_________________Age_____Breed________Color_________ | ||||||||||||
| Physical Breeding Condition________________________________________ | ||||||||||||
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Breeding Method:___Artificial Insemination___Live Cover___Both *Pasture Breeding? Y/N *(Note: ASD Coverage not available on pasture breeding stallions without prior company approval.) |
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| Has a Semen Evaluation been done? ______If so, attach summary report of findings. | ||||||||||||
| Has the stallion received any drugs, nsaids, or anabolic or other steroids in the past year? If yes, please explain: | ||||||||||||
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| Any comments or concerns?:________________________________________________ | ||||||||||||
| _______________________________________________________________________________ | ||||||||||||
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_________________________________________ Signature of Veterinarian |
____________________ Date of Exam |
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_________________________________________ Address |
____________________ Phone Number |
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