Date Format: MM slash DD slash YYYY
Please list basics, with notes on markings if you know them. For example, Bay with star, right front pastern white. Please note brands if present.
Date Format: DD slash MM slash YYYY
Please note or list all intended uses of the horse standing for the purchase exam, in order of importance.
Please note special circumstances, requests, concerns or any issue you wish to convey regarding the horse, the exam or circumstances.
Please tick the box for each item of interest. This is NOT a commitment or contract for services, but an indication for us to discuss those items with you in more detail.
Please tick the box for each area of interest for imaging. This is NOT a commitment or contract for services, but an indication for us to discuss in more detail. Cost is up to 55.00 per image plus 52.00 PACS/Archiving Fee and 45.00 sedation fee. Ultrasonography is approximately 260.00 per site plus 45.00 sedation fee.
This form must be completed and signed by the person ordering the purchase examination and who is financially responsible for this service.
This field is for validation purposes and should be left unchanged.