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Chilled Semen Shipment - Domestic
Owner's Information
Stud Dog's Owner's Name
*
First
Last
Stud Dog's Owner Phone
*
Type of AI (Very Important)
*
Transervical
Surgical
Vaginal
Recipient Information
Recipient Name
*
First
Last
Recipient Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Recipient Phone
*
Recipient Email
*
I Would Like To Add Insurance To My Shipment (Check One)
*
Yes
No
I understand that there is a charge of $265.00 for the collection, preparation and packaging of the semen. The price includes shipping the semen via Federal Express within the USA (priority overnight). ***** Please check availability for Saturday Delivery and First Overnight***** Additional rates apply: Saturday $25.00 First Overnight $50.00 Federal Express offers Shipping Insurance; Insurance is $1.00 per $100.00 increment over $500.00. We recommend insuring for the value of the semen. FedEx must take possession of the package for insurance to be valid.
Additional Insurance Amount
Payment Information
Name on Card
*
First
Last
Card Type
*
American Express
Discover
Master Card
Visa
Card Number
*
Expiry Date
*
Security Code on Back
*
Billing Zip Code
*
I Authorize Rose City Veterinary Hospital To Charge My Credit Card In The Amount Of: (Please Add $265.00 + Additional Fees Such As Insurance Or Sat Delivery)
*
Electronic Signature (type name)
*
By submitting this document to Rose City Veterinary Hospital. YOU AGREE TO PAY ABOVE TOTAL AMOUNT ACCORDING TO CARD ISSUER AGREEMENT (MERCHANT AGREEMENT IF CREDIT VOUCHER
New Clients
About Us
Make an Appointment
Location & Hours
Team
Services
Baer Hearing Test
Cardiology
Health Certificates
In House Laboratory
Otoplasty
Products
Rehabilitation and Wellness Center
Reproductive Services
Stud Services
Stem Cell Therapy
PRP Therapy
VIMAGO™ IMAGING
Resources
Just Food for Dogs
Emergency Vet Resources
How-To Videos
News
Online Forms
Payment Options
Pet Health Checker
Pet Health Library
Pet Food Recalls
Product Recalls
Pay Deposit Online
Referrals
Pet Health Insurance
Pet Portal
Pharmacy