Name Of Person Requesting PPE
(Required)
First
Last
Horse's Name
(Required)
Owner's Name
(Required)
Address Where The Horse Is Located
(Required)
Potential Buyer's Name
(Required)
First
Last
Potential Buyer's Phone Number
(Required)
Who Is Paying For The PPE?
(Required)
Which Vet Do You Prefer?
(Required)
Dr. McLendon
Dr. Reynolds
Dr. Reidy
Dr. Mayhew
Dr. Winkles
Dr. Erwin
No Preference
What Dates Are You Requesting To Have The PPE Done?
(Required)
Can You Haul In Or Do You Need Us To Go To The Location Of The Horse?
(Required)
Will The Potential Buyer Be Present For The PPE Or Someone Else?
(Required)
Do You Want Xrays?
(Required)
Yes
No
If Yes, Where?
Hocks
Stifles Navicular (Front Feet)
Back
Neck
Fetlocks
Coffin Bones
Do You Want A Call After Flexions Before Taking Xrays?
Yes
No
If Yes, Please Provide Name & Number Of Who We Are Calling
Do You Want A Drug Screen Or Hold Blood For 6 Months?
(Required)
Yes
No
Please Check One
Drug Screen
Hold Blood
Any Concerns You Want Noted For The Vet?
(Required)
Will You Need A Health Certificate?
(Required)
Yes
No
Please Provide Your Phone Number & Email So We Can Contact You To Schedule The PPE.
Phone
(Required)
Email
(Required)
We Will Also Need The Email Address Of The Person Paying For The PPE So We Can Email Pricing. We Will Need That Signed & Returned To Us Before The PPE. Email
(Required)
Is there anyone other than the person paying for the PPE (trainer, etc) that you want to have authority to make decisions regarding the PPE? If yes, please list their name and include any limitations on spending, etc. in the box below. If no, simply type, "no" in the box below.
(Required)
Thank You!