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Name of Owner: ________________________________________________________________
Contact Person: __________________________________________
Mare’s registered name: ___________________________Barn name: _____________________
Breed:____________________ Registration #________________________________________
Tattoo: ____________________ Brand: _______________Location: ______________________
Age: _______________________Color: _______________
Is this horse insured? _____________________________
What do you feed your mare and how often? (Oats, LMF, grass/timothy and alfalfa hay are
available. You are welcome to bring your own feed.)
If you feed a supplement or daily dewormer, you must provide it.
Do you want your mare (check one) Stalled__Stall w/daily turnout__pasture board___?
All mares need daily exercise in the form of turnout, riding or lunging. Please describe what you
prefer for your horse and whether or not you will provide it or prefer that we do. There are miles
of trails on which your horse can be hacked, the use of an indoor arena at a neighboring farm, and
an outdoor round-pen for lunging. Also, there are 5 acre fields (4’6” - 5’6” wood fencing) with
good grass for turnout if your horse is used to being on grass. On warm nights, the mare is
welcome to be out all night with your approval. Please provide your horse’s bridle if she is to be
A hard hat must be worn while riding. NO EXCEPTION
Please complete if foal by side or mare is in foal
Foaling Date: _________________________Gestational Days: __________________________
Problems associated with foaling (ie retained placenta, excessive bleeding, malposition of foal,
assistance required, etc.): _________________________________________________________
Abnormalities of foal: ___________________________________________________________
Were the foal and mare examined by a veterinarian within 24 hours of birth? ________________
Abnormalities found: _____________________
IgG level of foal: ________________________
Tetanus antitoxin: ________________________
Mare Reproductive History
(Please provide past records)
Previous foals (list dates): ________________________________________________________
Any problems associated with foaling? ______________________________________________
Has mare been bred without conception (list dates): ____________________________________
Abortion (please include cause if known):____________________________________________
Early embryonic death (before day 50): ______________________________________________
Has your mare been on Regumate or progesterone injections? ____________________________
At what stage(s) pregnancy or cycle?_______________________________________________
Has your mare had adverse reactions to any medication? ________________________________
Does the mare show heat? ________With foal at side? _______________
Approx. length of estrous cycles _________ days.
Is the mare cycling every 21 days? ______________________________
Has an endometrial culture been performed? ______ Results: ____________________________
Endometrial biopsy? ____________________________________________________________
Please list any behavioral abnormalities: _____________________________________________
Is the mare/foal on any medication? ______ Please list: _________________________________
Contact person (owner/manager): __________________________________________________
Telephone/Fax/ Mobile: __________________________________________
Type of insemination (please check all that apply):
Natural service: __________ Artificial insemination: ___________
Fresh cooled semen: ________ Frozen semen: ___________
Please describe your arrangement with the stallion manager regarding breeding or shipment of
semen (ie when is semen available? who calls for it? By what time must an order be placed? If
frozen, how many straws are shipped and what size are they? What courier service is used? How
long after placing an order will semen be received? Etc.) Remember to fill out all paperwork
and make payments for the semen in advance!
Check and double check that all paperwork is
Please provide any additional information that may be useful:
-Owner agrees to pay all charges for services under the terms of this agreement on or before the first day of the
month following the month of billing, while horse is under the care of Honahlee. Payment is to be made to Honahlee
at the address specified in the invoice. The amount of the fees to be paid for the charges are for general services
furnished by or in behalf of Honahlee and are to be charged per the fee schedule being used by Honahlee at the time
the services are performed. Charges for services not scheduled are to be charged at the usual and customary rates.
Any payments not made within (30) days after due shall bear interest from the due date at a rate of twelve percent
(12%) per annum. Accounts must be paid in full at time of departure from breeding facility.
-Owner agrees to indemnify and hold harmless Honahlee, its officers, directors, employees, agents and
representatives against any and all claims, including third party claims, for injury, sickness and/or death of any mares
inseminated by Honahlee.
-Honahlee makes no warranty of any kind whatsoever, express or implied, including but not limited to the fertilizing
capacityof any semen processed, stored, or ordered under this agreement, and hereby disclaims all warranties,
including WARRANTIES OF MERCHANTABILITY or fitness for a particular purpose.
-Any person signing this agreement as the agent of the Owner warrants and represents that he or she has full, express
authority to do so and legally bind the Owner.
PETER DAVID EISENBERG, M.D., FACP PROFESSIONAL Address: 1350 South Eliseo Drive, Suite 200 Greenbrae, California 94904-2007 EDUCATION 1963-67 M.D., Hahnemann Medical College, Philadelphia, Pennsylvania Internship: Internal Medicine Jacksonville Hospitals Education Program University of Florida Residency: Internal Medicine, Graduate Medical Education Jacksonville Hospitals E
GARA 2012 7 26 osteguna Mato KNEZ Geruza Atomikoen Estalketaren Teknikan (ALD) nazioarteko adituaKimikan aditua, Stuttgart-eko (Alemania) Max Planck Institute of Solid State Research-ean doktoretza burutu zuen2003an Kroaziako ikerlariak. Hamar urtetik gorako esperientzia du Italiako, Alemaniako, Koreako eta AEBetakoegoitzetan, eta aurten, Gaede Prize sari esanguratsua lortu du ALD teknikar