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About
- Meet the Team
- Reviews
Our Services
Client Education
Online Pharmacy
New Patient Center

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Prepurchase Seller Form

Prepurchase Seller Form

Pre-Purchase SELLER Information

Date

Seller’s Information

Name

Address

Phone

Seller’s agent

Name

Phone

Buyer’s Name/Agent

Name

Phone

Horse’s Information

Barn name

Breed

Registered Name

Registration #

Gender

USEF#

Birth date or age

Tattoo

Color

Microchip#

Amount and type of work this horse has been in:

Has this horse been out of work any significant length of time in the past 2 years? Explain.

**Please be aware that included in our pre-purchase evaluation includes watching the horse go under saddle. Please be prepared to tack up the horse and have an area available to ride for either you or the buyer.

Questions for Seller:

How long have you owned this horse?

Or how long has it been in your care?

When was the last time Strangles was present on your property?

Vaccine History

Please write date last vaccine

Tetanus

EEE/WEE/West Nile

Rabies

Flu/ Rhino

Strangles

Date of last Deworming/ Product

*Please attach a copy of the current Coggins Certificate.

*Please have your vet forward all medical records to [email protected]

Please indicate if this horse has experienced any of the following while you have owned him/her, or to the best of your knowledge prior to your ownership.

Colic Diarrhea Eye disease Cough Respiratory infection/disease Symptoms of gastric ulcers Surgery of any type Lameness

If surgery has been performed? Please elaborate below and provide dates:

Has this horse had any injuries or lameness requiring treatment? Please elaborate and provide dates.

Has this horse had a gastroscopy performed? Please provide date and findings

Please answer the following questions to the best of your knowledge. If yes, please elaborate and provide dates when applicable.

Does this horse have any vices?

Yes No

Is this horse currently on medication of any type?

Yes No

Is this horse fed supplements of any type?

Yes No

Is this horse currently receiving a nonsteroidal anti-inflammatories (such as Bute)?

Yes No

Is this horse currently receiving an oral or injectable joint supplement?

Yes No

When worked during hot weather, does this horse sweat normally?

Yes No

Has this horse ever hurt any human or other horse?

Yes No

Has this horse ever had any joints injected?

Yes No

Have radiographs been take for any reason?

Yes No

Does this horse have any allergies?

Yes No

Is this horse currently insured?

Yes No

Has a medical or surgical claim ever been filed for this horse?

Yes No

Has this horse ever been denied insurance coverage?

Yes No

Other:

Mare-Specific Questions

Has she ever been bred?

Yes No

How many times was she bred before she conceived?

How many foals has this mare delivered?

Alive

Dead

Died during the first month of life

Has she ever been diagnosed with a uterine infection?

Yes No

Has she had a uterine biopsy?

Yes No

Anything else of note:

Stallion-Specific Questions

Has he ever had a problem with fertility?

Yes No

Has his semen ever been examined?

Yes No

Are there any problems with libido?

Yes No

Gelding-Specific Questions:

Have both testicles been removed?

Yes No

I certify that the information I am providing regarding the horse described above is true and accurate.

I also certify that no medications have been administered to this horse within the last 72 hours.

For signature of seller/agent please enter your complete name thanks

Date

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Tuesday

9:00 am - 5:00 pm

Wednesday

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Thursday

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Friday

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Saturday

Emergencies

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Triangle Equine

(919) 460-6300

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