Pre-Purchase Form

Pre-Purchase Examination Agreement

We are pleased that you have chosen Unionville Equine Associates, PC to perform your pre-purchase exam. This form will explain the services included in the exam and describe additional services available to you. Our pre-purchase fee is $375.00 which includes a physical and soundness exam. Other services can be provided at an additional charge, please contact our office for specific fees.

The additional procedures that can be preformed include radiography, hematology, blood chemistry, drug screening, fecal test, breeding soundness exam and an endoscopic exam. There are many factors that should be considered as to whether these procedures would benefit your pre-purchase exam. The veterinarian performing the exam will contact the potential buyer to review the options available as well as to address any questions prior to the exam. After the exam the veterinarian will contact the potential buyer to review his or her findings. A written copy will also be provided.

The pre-purchase exam is intended to provide the buyer with an opinion of the condition of the horse prior to the purchase. This opinion is based on what is found on the day of examination and is not meant to be predictive for future soundness and suitability for various disciplines. This form must be completed, signed and returned to our office prior to the exam date. Payment is required at the time of service by credit card and is non-refundable.

Please note if the exam is not preformed at our clinic, a farm call fee which is determined by location will be charged and if radiographs are preformed a set up fee of $60 will apply.

Contact Information
In order to be able to contact you about your request, please fill the fields below

* Your name:

Your Email Address:

AND

Your Phone:

Your Address:

City:

State:

Zip:

Additional Services Requested ~ Fee Applies
Any items left unchecked must be discussed prior to the exam with the veterinarian.

CBC/Blood Chemistry/Fibrinogen:

Endoscopic Exam:

Coggins:

Fecal Parasite Test:

Drug Test:

Breeding Soundness Exam:

Digital Radiographs:
(front feet and hocks ONLY)

Lameness Locator:

Additional Radiograph Views:
(please specify)

Please complete the following:

Doctor Requested:

Horse's Location:

Horse's Current Owner/Agent:

Phone Number(s):

Horse's Name:

Breed:

Gender:

Color:

Age:

Buyer's Name:

Phone Number(s):

	A credit card must be supplied to our office within 24 hours of the submission of this form. The exam will not be scheduled until a credit card is supplied to our office.
	I understand I must contact Unionville Equine Associates, P.C. by phone within 24 hours of the submission of this form with my credit card information in order for my pre-purchase exam to be scheduled.

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