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Pre-Purchase Examination Form - Part 1
Please read all the
guidance notes
to the left, before completion.
Purchaser Title
Purchaser First Name
*
Purchaser Last Name
*
Purchaser Email Address
*
Preferred Phone Number
*
I confirm that I am over 18 years of age
*
Yes, I am over 18 years of age
Are you an existing client of Pinkham Equine?
*
Yes
No
Purchaser Address
Address Line 1
*
Address Line 2
City
*
County
*
Postcode
*
Vendor Information
Vendor Title
Vendor First Name
*
Vendor Last Name
*
Vendor Email
Address Line 1
*
Address Line 2
City
*
County
*
Postcode
*
Location of Horse
*
Phone Number
*
Details of Horse
Name
*
Age
Sex
*
Female
Stallion
Gelding
Breed
Colour
Proposed Use
Price
Is the horse to be insured?
*
Yes
No
Unsure
Concerns (if none, please type 'none')
*
Additional Procedures
If you opt in to any of the additional procedures listed below, the veterinary surgeon will contact you to discuss your requirements. Please note that
ADDITIONAL FEES WILL APPLY
for any additional procedures that are selected.
Are X-Rays required?
*
Yes
No
is Ultrasound required?
*
Yes
No
Is endoscopy of the upper airways required?
*
Yes
No
TAKE VDS blood sample to store for 6 months so available for drug testing if needed?
*
Take VDS Blood Sample
DO NOT take VDS Blood Sample
PLEASE NOTE: If you are NOT AN EXISTING CLIENT of Pinkham Equine, you will need to pay for this service when submitting this form.
Perform general health blood testing:
*
Yes - perform general blood testing
No general blood testing
Note that ADDITIONAL FEES apply for this service. If you are NOT AN EXISTING CLIENT of Pinkham Equine, you will need to pay for this service when submitting this form.
Perform strangles blood testing:
*
Yes - perform strangles blood testing
No strangles blood testing
Note that ADDITIONAL FEES apply for this service. If you are NOT AN EXISTING CLIENT of Pinkham Equine, you will need to pay for this service when submitting this form.
Who are the current vets of the horse?
Visit Fee
Our standard visit fee covers a 25-mile radius of the practice. Longer visits will incur an additional fee.
5 Stage Vetting Fee
Are the following facilities available?
Dark Stable
*
Yes
No
Flat, level surface for trotting up
*
Yes
No
Firm, flat non-slip surface for lunging
*
Yes
No
An arena suitable for riding and lunging in?
*
Yes
No
Declaration
Declaration
*
I acknowledge that I have read the form and wish to proceed with the vetting.
Name
*
Date
*
Day
Month
Year
Name
This field is for validation purposes and should be left unchanged.
