LOSS OF PREGNANCY REPORT

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Mare Owner


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Mare				Registration #

I am a graduate veterinarian currently licensed to practice in this state.

I examined the mare listed above on this date and determined that she failed to settle, aborted, or delivered a foal which failed to stand and suck.
I believe the mare received reasonable care during pregnancy, including normal immunizations and worming for pregnant mares.

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Signature			Date

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Veterinarian’s Name, Address & Telephone Number

Instructions:
1. This report must be received by LDF Farms within 10 days after the loss of pregnancy is discovered.
2. The circumstances of the loss of pregnancy should be described on the back of this report.