Sondel Family Veterinary Clinic

Transfer of Ownership of Frozen Semen Form

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Transfer of Ownership of Frozen Semen Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet before your visit.

TRANSFER OF OWNERSHIP OF FROZEN SEMEN

All sire owners or semen owners on record at the time of collection MUST sign this form to transfer ownership of the frozen semen listed below. This document, when completed, signed and dated, transfers the ownership of the frozen semen listed to the new owner(s).

Name of the current frozen semen owners *

Email *

I (we), do hereby transfer all rights of ownership and interest in the following frozen semen, its use, and resultant offspring to the new owner(s) listed below.

Registration Number of Dog

Name of Dog

Breed of Dog

The following semen from the above dog is to be transferred to the new owner(s) listed below.

Date of Collection

Number of straws/vials

Equaling breeding unit(s)

I (we) do transfer all ownership and interest in the frozen semen specified above from the above designated dog to:

Name of new owner(s) *

Telephone number *

Address of new owner *

I (we), being the sole owner(s) of the frozen semen from the above designated dog, realize that all interests, ownership and liability in the above listed frozen canine semen and its resultant use, offspring produced from it, and/or its transfer to other individuals are no longer mine/our concern and now belong to the person(s) listed above as the new owners.

Date *

Signature(s) of current semen owner(s) *

Clear Signature

Date *

Signature(s) of new semen owner(s) *

Clear Signature

West Madison Clinic

East Madison Clinic

Phone

Sondel Family Veterinary Clinic

Transfer of Ownership of Frozen Semen Form

Transfer of Ownership of Frozen Semen Form

TRANSFER OF OWNERSHIP OF FROZEN SEMEN

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West Madison Clinic

Address

Contact Details

Hours

East Madison Clinic

Address

Contact Details

Hours