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Faqsnew York State Thoroughbred Breeding Nybreds Form

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© 2017 - Cottonwood Equestrian Publications MARE INFORMATION SHEETTo Be Kept By: ____________(Fill out one for each mare to be bred) Owner's Name Phone No. (h)(as recorded with the Registry) (w)Address StreetCityStateZipHorses Name and NumberFoaled ColorMarkingsAnticipated arrival date Foal at Side?Sire of Foal Date/last foalingDoes Horse have any dangerous propensities? If yes, describe: Stallion to which mare shall be bred:Medical History of Horse:ColicFrequencyFounder WhenAllergies, if knownOtherTetanus Toxoid DateVEEEncephalomyelitis (sleeping sickness), Eastern & Western StrainsDate of last worming Coggins TestFeeding Program: Hay typeAmountGrain type(s)Amount PelletsAmountKnown allergies to feeds Special Care RequirementsHabits To be contacted in case of emergency, if owner cannot be reached:Name Phone Number Addres s Is Horse insured? Insurance Carrier Policy #Carrier's Address Insurance contact for emergencies and phone number:Veterinary emergency contact:NamePhone NumberThis Horse is/is not considered a surgical candidate in the event of colic or serious illness (check © 2017 - Cottonwood Equestrian Publicationsone). _____IS _______IS NOT Owner's Initials_______

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