Equine Reproduction Lab

University of Wisconsin-Madison

Madison, WI 53706

Ph. (608) 263-7698

Fax (608) 262-5157

Equine Cooled Semen Transport Sheet

Horse Information

Semen Collected From: / Semen Shipped To:
Stallion Name: / Mare Name:
Farm/Owner: / Farm/Owner:
Address: / Address:
Phone #: / Phone #:

Semen Information

Collection Date: Time:

Volume (Gel-Free) mls

Sperm Concentration million/ml

Total Number of Sperm in Ejaculate billion

Sperm Motility: % (Raw)

% (Extended)

Sperm Morphology: % Normal

% Primary Abnormalities

% Secondary Abnormalities

Extended Semen Information

Semen Concentrated: Y N

Semen Extender Used:

Antibiotic(s):

Volume of Raw Semen per shipped dose: mls

Volume of Semen Extender per shipped dose: mls

Total Volume of Extended Semen per shipped dose: mls

Total Number of sperm per shipped dose: billion

Insemination Information

Insemination (s) #1 Date/Time: Motility: %

#2 Date/Time: Motility: %