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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.
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* Indicates required question
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Your answer
Horse Owner's Name
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Your answer
Horse Owner's HOME Address (please include town and zip code)
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Your answer
Owner's Phone Number (including area code)
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Your answer
Owner's Email Address
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Your answer
Barn Owner's Name (if same as owner of horse, write "SAME") and Barn name (if applicable)
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Your answer
Barn Address where Horse(s) resides (please include town and zip code). If same as horse owner's address, write "SAME"
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Your answer
Barn Owner's Phone Number
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Your answer
Horse's Show Name (if no show name, write N/A)
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Your answer
Horse's Barn Name
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Your answer
Breed
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Your answer
Color
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Your answer
Gender
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Mare
Stallion
Gelding
Date of Birth or Age of Horse (THIS YEAR)
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Your answer
Horse Services (select all that apply)
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Rabies Equine
4in1
5in1
West Nile Virus
Coggins
Strangles
Potomac Horse Fever
Other Services (please answer next question in more detail)
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
Your answer
How will you be paying for your Farm Call? (Check all that apply). Payment is expected at time of service.
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Cash
Check
Visa/Mastercard/Discover/American Express
Care Credit
Required
Additional Animal Services. Please include as much information as possible including which species needs what - Dog, Cat, Goat, Llama, Alpaca, Cow.
Your answer
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.
I'll pick up my paperwork
Mail my paperwork please
Clear selection
Do you need any medications brought out to the farm? We recommend having bute and/or banamine on hand for horses.
Your answer
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