IVF Client Agreement

IVF Client Agreement

Owner Details

Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
Country
Does owner currently have an account at Holbrook Breeders Australia?

Account Details (if different from above)

Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
Country

Animal Details

Maximum file size: 134.22MB

Has this cow had IVF ovum pick up previously?

Property of Origin of Donor:

Address
Address
City
State/Province
Zip/Postal
Country

Treatment Disclosure

Does the animal have any pre-existing conditions or ailments?

Semen Required for Fertilisation

Is the semen:

If a split join is required, please include second sire below:

Is the semen:

Acknowledgment

I the owner/legal representative agrees to pay all charges on dates specified on invoices presented. To the best of knowledge of the owner/legal representative all information provided on this form is correct. Australian Premier Genetics P/L will endeavour to provide a safe and adequate environment for the animals whilst in their care, taking all precautions to avoid accident or mortality. The risk of accident or mortality of the animal whilst in the care of APG is accepted by the owners and insurance coverage should be arranged or declined as necessary by the owner. No insurance is provided for animals on centre, in transit or semen stored at, or shipped by, Australian Premier Genetics Pty Ltd.