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Services
Forms
Pharmacy
- Prescription Requirements
- Pricing
Herd Health
- Deworming
- Vaccinations
Opportunities
- Externships
- Internships
About
In the Community
Contact

Forms

Pre-purchase Exam Request Form

If you have not already filled out a Veterinary Services Contract it must be done as well as the Pre-purchase Request Form. Thank you!

PLEASE NOTE: For pricing details, please see our Pre-purchase Examination Pricing List.

PRE-PURCHASE EXAMINATION REQUEST FORM

PLEASE BRING TACK AND BE PREPARED TO RIDE.

Purchaser's Info
Purchaser's Name
First Last
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Purchaser's Agent
First Last
Phone
Horse Info
Name of horse being examined
Intended use of horse
Age
Breed
Sex
Color
Seller's Info
Seller's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Seller's Agent
First Last
Phone
Place of Prepurchase
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Exam Info
The basic prepurchase exam consists of a physical exam which includes examination of the eyes, heart and lungs; hoof tester exam; moving exam; and flexions. The following services are available, but are not included in the basic exam:
Radiographic Exam
- Front Feet
- Knees
- Stifles
- Front Fetlocks
- Hocks
Ultrasound Exam
- Tendons
- Suspensories
- Reproductive Tract
Endoscopic Exam
- Airways
Blood Work
- CBC/Chemistry
- Drug Screen
- Coggins
- Additional examination to be left to the discretion of the examiner
Riding*
- I understand that the exam will require riding, and will bring tack and be appropriately prepared for such.
Payment Authorization*
- I understand that a valid credit card number will need to be supplied and that card will be charged for the full amount of the Prepurchase Exam within 24 hours of the completed exam. Please contact the office for an estimate of services.
Other requests
Veterinarian's Name
First Last
Date of Appointment

4122 Zulla Rd, The Plains, VA 20198
(540) 364-4950
Fax: 540-364-4987
officestaff@piedmont.vet

OFFICE & PHARMACY HOURS

Monday-Friday
8 AM –5 PM
Closed weekends

We are available 24/7 for ambulatory
emergencies within a 35-mile radius of
the clinic at 540-364-4950. After hours
you will be connected to our answering
service, which will contact the doctor on call.

Our hospital is always available for
emergencies, and if you are out of the
35-mile radius, you are welcome to ship
in to us.

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