Radiograph Interpretation Form

Sale:

Hip #:

Horse's Registered Name:

Horse's Age:

Intended Use for the horse:

Please attach Radiographs and any other medical records:

Name of buyer

Name of Buyer's Agent:

Seller or Seller's Agent

Seller or Seller Agent Phone:

Buyer's Billing Email

Buyer's Phone Number:

Buyer Agent's Phone Number:

Horse's history:

Credit Card Number

I am aware that Radiographic Interpretations will be charged $200

If a BOVPS sends the images to a Boarded Radiologist for another opinion, there will be additional costs added.

Expiration Date

Security Code:

Billing Zip:

I request that the aforementioned horse's films be examined for purchase. The Pre-Purchase radiographic interpretation is no guarantee of future soundness and suitability. We review the provided films for any radiograph lesions and findings only.

Please acknowledge the following:

That we perform this examination only at the request of the buyer or their agent. That the films provided to us from the repository or another veterinarian, were not taken by Bur Oak Veterinary & Podiatry Services (BOVPS), we make no guarantees to their representation. That BOVPS does not see the animal in person or video prior to or during review of these digital images. Results provided are based solely on the images provided in the sales repository or submitted to us by another veterinarian or buyer/seller's agent. We recommend that the buyer or their agent, when possible, witness the horse in person. That review of these films may not reveal subtle unsoundness or medical issues.

The purchaser/buyer acknowledges that a material condition of BOVPS and its veterinarians to perform this pre-purchase examination is the purchaser's agreement to release, waive, and discharge BOVPS and its veterinarians and employees from all claims arising directly or indirectly from the performance of the pre-purchase examination; this is a promise by the purchaser not to sue. The horse will not receive a "pass" or "fail" grade. We encourage the buyer and their agents, trainers and local veterinarians to discuss the findings with our veterinarian in order to gain a comprehensive understanding of the horse's condition on the day of the exam only, as it relates to the intended use. The final decision to purchase the horse based on the information available lies solely with the buyer.

The signature below indicates that you have read and agree to the terms set forth in this agreement.

Signature

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