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ARTIFICIAL INSEMINATION (AI) CERTIFICATE

THIS MUST BE COMPLETED BY THE ATTENDING VETERINARIAN / TECHNICIAN . PLEASE ENTER THE LAST SERVICE AI DATE AND SELECT THE PTIF RESULT (POS/NEG)
(One copy will go to the stallion owner and one copy to the mare owner. The information provided where relevant will be lodged with the Australian Quarter Horse Association for Breeding Return purposes.)

First name*

Last name*

Mare name & rego no.*

Email*

Name of Practitioner*

Practitioner Mobile No.*

I, the Veterinarian / Technician named below hereby certify that the abovenamed mare was inseminated with:

Stallion*

From the quarter horse stallion named below

Semen Type*

Fresh Chilled

Frozen

AI Dates
You MUST complete the AI date, and at least 1 PTIF scan result

AI Attempt #1*

Enter AI date of 1st attempt

Day/Month/Year

PTIF 15 days (#1)*

PTIF 30 and/or 45 days (#1)

AI Attempt #2

Enter AI date of 2nd attempt

Day/Month/Year

PTIF 15 days (#2)

PTIF 30 and/or 45 days (#2)

Veterinary Clinic*

Please get in touch with our Semen Logistics Liaison, Billie Buckeridge on 0402 308 304‬ if your Veterinary Clinic doesn't appear on our list of preferred clinics.

Other Vet Clinic

I, the attending veterinarian/ technician named above, understand that by completing this Artificial Insemination (AI) Certificate I hereby attest that the abovenamed mare was identified to match her AQHA Registration No. (if applicable) and that the mare was inseminated with the semen from the quarter horse stallion shown above.

I also understand that this information will be used by the stallion owner for analysis and lodgement with the AQHA.

ARTIFICIAL INSEMINATION (AI) CERTIFICATE

AI DatesYou MUST complete the AI date, and at least 1 PTIF scan result

AI Dates
You MUST complete the AI date, and at least 1 PTIF scan result