Coggins Form

Name: Brandon Equine Medical Center
Address: 605 E Bloomingdale Ave, Brandon, FL, 33511, United States
Telephone: 813-643-7177
Price range: $

Thank you for taking the time to complete this form!

Upon receipt of your horse’s Coggins please review it immediately and inform the office within 3 weeks of the blood draw date if there are any corrections that need to be made. Corrections cannot be made once the 3 weeks has been exceeded.

Registered Name *

Non-Registered Name *

Breed *

Color *

Age/DOB *

(Please note: if only an age is given, the DOB month and day will be January 1)

Gender *

Mare
Gelding
Stallion

Specify Markings: Head and Limbs/Tattoos/Brands

Owner's Name *

First

Last

Email *

Owner Phone Number *

Owner's Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Horse Location: *

At above home address
Boarding facility

Phone

Expert equine care in Brandon, FL.

From our board-certified horse surgeons and board-certified internists to our professional and courteous staff, at Brandon Equine Medical Center, we are committed to the health and well-being of all breeds and sizes of horses. In the field, as an outpatient, or when admitted to the horse hospital, we treat every horse like our own and every client as the most important.

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Contact Info

Phone: 813-643-7177
Fax: 813-643-5877
Email: info@brandonequine.com

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Hours

Monday – Friday: 8AM-5PM
Saturday & Sunday: Closed
Emergency care available: 24/7/365

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Location

605 E Bloomingdale Ave
Brandon, FL 33511
Click here for directions.

Have a question?

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If this is an emergency, please call us directly at 813-643-7177.

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