Cooled Semen Shipment Request Form – Palm Beach Equine Clinic

Please send all requests to: ashlee.griffin@equineclinic.com

Stallion: Stallion Owner:

Requested Shipping Date:*

Cooled:

Equitainer: Transport Box:

Cooled:

Mare Owner: Mare Name:

Phone*

Email*

Veterinarian Clinic:

Phone

Email*

Shipping Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cooled Semen: Requests must be received before 5:30 PM EST the day before the date of collection. Same day collections requests will be accommodated, if possible, with a late booking fee. The semen collection, processing, and transport box for cooled semen is $385 plus shipping cost. PBEC is not responsible for the costs arising from shipments, lost, damaged, or delayed in transit. We have no control of the shipment once it leaves our facility. There will be no refunds given for lost or delayed shipments. A cancellation fee of $150 will be charged to the credit card for cancellations made on the same day. No semen will be dispatched without authorization by the stallion owner or agent.

Authorization For Payment

Cardholder Name: Credit Card #: CVV:

Expiration Date:

Fedex Account #:

If applicable

Billing Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please be advised that a 3% processing fee applies to all credit card transactions. ACH payments are accepted at no additional cost. Payment is due at time of service. Please note that requests will only be processed with a valid credit card authorization on file.

Palm Beach Equine Clinic
13125 Southfields Rd, Wellington FL 33414 Office: (561) 793-1599