NORTH AMERICAN PERUVIAN HORSE ASSOCIATION
NAPHA Embryo Transfer Program Report on Flushing/Transfer
Name of Mare_____________________________________NAPHA #_______________
Name of Sire_____________________________________NAPHA #_______________ Location where flush procedure is performed_____________________________ Date(s) bred___________________________Date of Flush____________________ An embryo [ ] was not recovered [ ] was recovered Number of Embryos Recovered____________ Number Transferred___________ Veterinarian who performed flush/E.T.___________________________________ Address____________________________________________________________ Phone______________________________________________________________ Hospital/Univeristy Affiliation ___________________________________ The embryo was transferred to the recipient mare: [ ] non-surgically [ ] surgically The recipient is a mare named___________________________________________ Breed _____________________________Color___________________________ Markings___________________________________________________________ Signature of Mare Owner(s)______________________________________________ Date____________________________________________________________________ Signature of Veterinarian Performing E.T. ______________________________ Date____________________________________________________________________
This Report must be filed by January 10th of the year following the flushing which it documents. File 1 form for each embryo transferred. Fine for late filing: $ 50
Contact NAPHA at:
3095 Burleson Retta Road
Burleson, Texas 76028
Tel: (817) 447-7574 Fax: (817) 447-2450
e-mail: info@pphrna.org