Frozen Semen Shipment Request Form – Palm Beach Equine Clinic

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

Stallion: Stallion Owner:

Requested Shipping Date:*

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

Frozen Semen:There is a $300 frozen semen transfer charge to all shipments, in addition to FedEx priority overnight shipping fees for the frozen semen dose(s) and return shipment of the dry shipper back to Palm Beach Equine Clinic. Requests must be received 48-Hrs prior to shipment date. If you require a same day or next day shipment, an Express Fee of $140 will be applied and will only be accommodated if possible.

No semen will be dispatched without authorization by the stallion owner or semen 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