Mare Care Form

To Be Kept By: Bar A Ranch
(Fill out one for each mare to be bred)

Owner's Name _________________________     Phone No. (home) __________________

(As recorded with the Registry)

(work) ________________________ Cell: _______________
Address:____________________________________________________________________________

Horses Name and Number ___________________________________________Foaled_____________ Color _______ Markings ________________________Anticipated arrival date _____________ Foal at Side?___________________
Sire of Foal ______________________ Date/last foaling___________________Does Horse have any dangerous propensities? If yes, describe:_______________________________________________________________________
Stallion to which mare shall be bred:_____________________________

Medical History of Horse: Colic__________________ Frequency________________Founder____________________ When______________________Allergies, if known______________________________________________________
Other_______________________TetanusToxoid________________Date____________________________________
Encephalomyelitis (sleeping sickness), Eastern & Western Strains_________Date of last worming____________ Coggins Test_________________Feeding Program: Hay type ______________ Amount______________________
Grain type(s) _______________Amount_________________Pellets ______________________ Amount____________________________
Known allergies to feeds _____________________Special Care Requirements ____________________________
Habits________________________________________________________________________

To be contacted in case of emergency, if owner cannot be reached:
Name ______________________________Phone Number______________________________________________
Street                                                           State              Zip______

Is Horse insured?_________Insurance Carrier ____________________ Policy #___________________________
Carrier's Address ____________________________________________

Emergency contact:__________________________

Insurance contact for emergencies and phone number:______________________________________________
Veterinan __________________________________________________________________________________
                                            Name                                              Phone Number
This Horse is/is not considered a surgical candidate in the event of colic or serious illness
(check one). _____IS _______IS NOT

Owner's Signature _____________________________________  Date_____________________