Farm Call Horse Registration Form
Thank you for filling out this form in advance prior to your farm call. This will help us keep accurate record to better serve you and your animals. Please include as much information as possible when listing any concerns that need to be evaluated. We may contact you prior to your farm call to get additional information. If you have any questions, please feel free to call the office during regular business hours at 585-548-9097.
Sign in to Google to save your progress. Learn more
Date your Farm Call is Schedule for *
Horse Owner's Name *
Horse Owner's HOME Address (please include town and zip code) *
Owner's Phone Number (including area code) *
Owner's Email Address *
Barn Owner's Name (if same as owner of horse, write "SAME") and Barn name (if applicable) *
Barn Address where Horse(s) resides (please include town and zip code). If same as horse owner's address, write "SAME" *
Barn Owner's Phone Number *
Horse's Show Name (if no show name, write N/A) *
Horse's Barn Name *
Breed *
Color *
Gender *
Date of Birth or Age of Horse (THIS YEAR) *
Horse Services (select all that apply) *
Required
Other Horse Services. Please include as much information about issues or other services required. If this is an urgent matter - please call the office at 585-548-9097
How will you be paying for your Farm Call? (Check all that apply). Payment is expected at time of service. *
Required
Additional Animal Services. Please include as much information as possible including which species needs what - Dog, Cat, Goat, Llama, Alpaca, Cow.
Coggins paperwork takes approximately 2-3 weeks to return to our office. Do you need paperwork picked up or mailed when it arrives? Rabies certificates will be available to picked up or mailed as well.
Clear selection
Do you need any medications brought out to the farm?  We recommend having bute and/or banamine on hand for horses.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy