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Frozen Semen Shipment - Domestic
Owner's Information
Stud Dog's Owner's Name
*
First
Last
Stud Dog's Owner Phone
*
Breed
*
Recipient Information
Recipient Name
*
First
Last
Recipient Phone
*
Recipient Email
*
Shipping Information
Clinic or Recipient Name
*
Recipient Address
*
Street Address
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I Agree to the Added Insurance Costs to My Shipment
*
I Agree
I, the undersigned, do authorize Rose City Veterinary Hospital to charge my credit card for the processing of frozen semen. I understand that the charge is $595.00 for frozen semen processing, and one week of tank rental this fee also includes shipping the semen via Federal Express within the USA. Tank rental is $15.00 per day after the initial week. *** Please check availability for Saturday Delivery and First Overnight as there are some areas that do not provide these services*** Additional Rates may apply for Saturday Delivery or First Overnight In addition, with less than 24 hours notice there is an additional $200.00 fee; for 48 hours notice there is an additional $100.00 fee. By submitting this form you understand that if the tank is not returned within 30 days or it is returned damaged, you understand that your credit card will be charged in the amount of $1200.00 for replacement fees. 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 $595 + Additional Fees Such As Insurance Or Sat Delivery)
*
Electronic Signature (type name)
*
By submitting this form you authorize Rose City Veterinary Hospital to charge your credit card in the amount mentioned above. I also understand in the event the tank is not returned or is returned damaged, Rose City Veterinary Hospital, will charge my credit card in the Amount of $1200.00. 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