Admission Form

Duration of ownership:

Current level of work:

What is your horse used for?:

Is your horse up to date with Flu and Tetanus vaccines?:

Yes
No

May we clip your horse if necessary?:

Yes
No

Is your horse up to date with worming?:

Yes
No

Does your horse have any allergies?:

Yes
No

If your horse does have an allergy or allergies, please provide details here:

Is your horse shod currently?:

Yes
No

(Please be aware these need to be removed for surgery and MRI)

Does your horse have any unhealed injuries?:

Yes
No

If your horse does have any unhealed injuries, please provide details here:

Does your horse have any habits?:

Yes
No

If your horse does have any habits, please provide details here:

Does your horse have any known heart problems?:

Yes
No

If your horse does have any known heart problems, please provide details here:

Does your horse have any history of tying up?:

Yes
No

Is your horse signed out of the food chain in the passport?:

Yes
No
Unknown

Is your horse on any current medication?:

Yes
No

If your horse is on any current medication, please provide details here:

In the last 30 days has your horse had symptoms of, or contact with any other horses with, infectious diseases such as Flu, Ringworm or Diarrhoea?:

Yes
No

In the last 30 days if your horse has had any symptoms or contact, please provide details here:

Any other history or illness? :

Any special precautions?:

Your horse may be lunged for a lameness assessment or a bone scan, how does your horse behave to being lunged?:

Hard Feed:

Hay / Haylage (soaked)?:

Is your horse insured?:

Yes
No

Country*: