AnnaBella Stables
Enclosure 1 On Farm Stallion Breeding Contract
REPRODUCTIVE HISTORY QUESTIONNAIRE
Section 1
1. Mare Name __________________________________________
2. Year of Birth __________________________________________
3. Reproductive status _____________Maiden (never been bred) ______
_____________Open/Barren
_____________Foal at side
_____________In foal
If this mare is maiden, or if this mare has been bred at AnnaBella Stables. in the past two years, you do not need to complete Section 2
and should go on to Section 3.
Section 2
4. How many foals has this mare had? _____
5. If the mare is open, when was she last bred? _____
6. Has this mare ever been treated for a uterine infection?_____
If so what type?
_____________Streptococcus
_____________E. Coli
_____________Klebsiella
_____________Pseudomonas
_____________Other
7. Has she had a uterine biopsy? _____ If so please provide copies of biopsy reports.
8. Has the mare ever conceived twins? _____
9. Has the mare ever aborted a pregnancy? _____ If so, in what month of gestation? _____
10. Has this mare ever been diagnosed as or treated as progesterone deficient? _____
11. Does this mare readily show signs of estrus (tease) when she is "in heat"? ______
12. As far as you know, does this mare display normal 21 day estrous cycles? ______
13. Where was she last bred? __________________________________________
Contact person _____________________________
Phone number _____________________________
14. Please advise us of any other pertinent information regarding your mare's reproductive history:
__________________________________________________________________________
__________________________________________________________________________
15. Please list the last vaccination date for your mare for the following vaccinations:
Influenza ______
Encephalitis______
Rhinopneumonitis ______
Tetanus ______
16. When was the last date your mare was wormed? ______ Which de-worming product was used? ________
17. Breed of mare: ____________________________
18. Would you have considered AI if offered by AnnaBella Stables? ______________________
19. Expected arrival date at AnnaBella Stables: ____________________________
20. Additional information about mare we should know: _____________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Please complete this form as soon as possible and return it with your signed Stallion Service Contract.. If you have questions or concerns
please call or email us at annabellastables@yahoo.com