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Semen Request Form

for Clermont Veterinary Surgery

A collection fee applies to this order. No payment is taken on this form.

Submit this form first. Once we receive it, our team will confirm the price with you (the collection fee, plus freight if applicable) and send you payment details by EzyVet payment link or bank transfer.

Semen will not be dispatched until payment has been received.
Freight is not included in the collection fee and is quoted separately based on your delivery method.
Orders must be received by 5:00pm the day before the requested collection date.
Please do not enter credit card details in this form. We are unable to take card details over the phone.

Questions before you submit? Call Clermont Veterinary Surgery on 07 4983 1172.

1. Mare Owner / Client Details

The person responsible for this order and for payment.

First Name(Required)

Last Name(Required)

Business / Stud Name

Leave blank if ordering as an individual.

Postal Address(Required)

Street Address Address Line 2 Suburb/Town/City State / Province / Region Postcode

Your billing / account address. Delivery address is collected further down.

Mobile(Required)

We will call this number to confirm your order.

Email(Required)

Your confirmation and payment details will be sent here.

Are you an existing client of Clermont Veterinary Surgery?(Required)

Yes

Not sure

Client / Account Number

If you know it. Helps us find your account faster.

2. Mare Details

Registered Mare Name(Required)

Mare Registration / Microchip Number

Breed / Registry

e.g. ASH, QH, Warmblood, Standardbred.

Number of Mares Covered by This Order(Required)

Please enter a number from 1 to 20.

3. Stallion and Collection

Please confirm the stallion is available for your requested date before submitting.

Stallion Name(Required)

Stallion Owner / Stud

Who stands the stallion, if known.

Number of Doses Required(Required)

Please enter a number from 1 to 20.

Requested Collection Date(Required)

DD slash MM slash YYYY

Orders must reach us by 5:00pm the day before this date.

Planned Insemination Date(Required)

DD slash MM slash YYYY

Have you confirmed stallion availability for this date?(Required)

Yes - confirmed with the stallion owner

No - please check for me

If not, we will check availability before confirming your order.

4. Inseminator / Attending Veterinarian

The person who will inseminate the mare. We contact them directly about dispatch and timing.

Inseminator First Name(Required)

Inseminator Last Name(Required)

Inseminator Practice / Clinic

Inseminator Mobile(Required)

Inseminator Email(Required)

5. Delivery / Dispatch

Freight is quoted separately and is not included in the collection fee.

Delivery Method(Required)

Road freight / courier - freight quoted separately

Airfreight - freight quoted separately

Pickup from Clermont Veterinary Surgery - by arrangement, no freight charge

We will confirm the freight cost with you before dispatch.

Delivery Address(Required)

Street Address Address Line 2 City State Zip Code

Destination Airport(Required)

The airport the semen should be flown to for collection.

Your Freight Account Number

Optional. If you have your own courier or airline account we can consign to, enter it here.

Special Delivery Instructions

Gate codes, depot hours, property access, after-hours arrangements, or anything else the driver needs to know.

Contact Name on Day of Dispatch(Required)

Who we call if there is a problem on the day.

Contact Mobile on Day of Dispatch(Required)

6. Payment and Terms

What happens after you submit

You will receive an email confirming we have your request.
Our team will confirm the price with you (the collection fee, plus freight if applicable).
We will send payment details by EzyVet payment link or bank transfer, as you prefer.
Once payment is received, collection is booked in and the semen is dispatched.

Submitting this form does not complete your order, and no payment is taken now. Semen will not be dispatched until payment has been received.

How would you prefer to pay once the price is confirmed?(Required)

Bank transfer - send me an invoice with bank details

Card - send me a secure EzyVet payment link

We cannot take card details over the phone. Either option is sent to the email address above.

Price and Payment Agreement(Required)

I understand the collection fee, plus any freight, will be confirmed to me by the clinic after I submit this form. I agree to pay it, and that semen will not be dispatched until payment has been received.

Terms and Conditions(Required)

I agree to the terms and conditions set out on this page.

Including the 5:00pm day-prior order cut-off, and that semen quality cannot be guaranteed once it leaves our care.

Anything Else We Should Know?

Contact Us

level 1/387 City Rd, South Melbourne VIC, Australia

+613 5445 5999

[email protected]

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About
Veterinary Services
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Apiam Locations
Partner with Apiam