Pre Purchase Information

Thank you for using Aiken Equine Veterinary Associates for your pre purchase exam. Please fill out the information below and our office will contact you to finish setting up your exam.

Buyer Information

Buyer First Name:
Buyer First Name
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Buyer Last Name:
Buyer Last Name
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Buyer Address:
Buyer Address
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City
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  • - Select a State -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
- Select a State -
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Zipcode
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Buyer Phone Number:
Buyer Phone Number
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Buyer E-mail Address
Buyer E-mail Address
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Buyer's Agent First Name:
Buyer's Agent First Name
Field is required!
Buyer's Agent Last Name:
Buyer's Agent Last Name
Field is required!
Buyer's Agent Phone number:
Buyer's Agent Phone number
Field is required!
Please Describe Horse's Intended Use:
Intended Use
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Seller Information

Seller's First Name:
Seller's First Name
Field is required!
Seller's Last Name:
Seller's Last Name
Field is required!
Seller's Address:
Seller's Address
Field is required!
City
Field is required!
  • - select a state -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
- select a state -
Field is required!
Zipcode
Field is required!
Seller's Phone Number:
Seller's Phone number
Field is required!
Seller's Email Address:
Seller's E-mail Address
Field is required!
Seller's Agent First Name:
Seller's Agent First Name
Field is required!
Seller's Agent Last Name:
Seller's Agent Last Name
Field is required!
Seller's Agent E-mail Address
Seller's Agent E-mail Address
Field is required!
Location of Exam:
Location of Exam
Field is required!

Horse Information

Horse's Name:
Horse Name
Field is required!
Horse's Sex:
  • - Sex -
  • Stallion
  • Mare
  • Gelding
- Sex -
Field is required!
Horse's Age:
Age
Field is required!
Date of Coggins:
Date of Coggins
Field is required!
Horse's Breed:
Horse's Breed
Field is required!
Please List Any Known Vices:
Vices:
Field is required!
Please List Any Medications Horse is Currently Taking:
Medications
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Please List Vaccination History:
Vaccination History
Field is required!
Date of Last Dental:
Select a date
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Please List Date of Deworming and Product Used:
Deworming History
Field is required!
Please List Joint Injection History, if applicable:
Joint Injections
Field is required!
Please List Other Medical History:
Medical History
Field is required!
Please List Competition History:
Competition History
Field is required!
Please List Any Medications Given During Competition:
Competition Medications
Field is required!
Ownership History:
Ownership History
Field is required!
Please Describe Horse's Current Workload:
Current Work
Field is required!
Please Describe Horse's Current Diet:
Current Diet
Field is required!