OWNER/HORSE INFO
Name: ___________________________________
Address: ______________________________
Email: _____________________
Phone: ___________________________
Cell: __________________________
Horse’s Name:
___________________________
Age: ____ Breed: _______________ Sex:
_____ Color: ___________________
Write up as complete a history as
possible covering the following or fill in the following in as much detail
as possible:
How long have you had this horse?
________
Was the horse raised stalled or natural?
___________________
What kind of living conditions has the
horse had over its life and now?
(Stall/natural)
____________________________________________
At what age was it first shod?
___________
For how long has it been shod?
_____________
Was it shod year round or kept barefoot
in the winter? ____________
What is/was the average period between
trims/resets? ______________
How is/was the horse used? Dressage,
western, jumping, etc? _____________
________________________________________________________________
What kind of feed/supplements is the
horse getting? Wormers? _____________
Any past health problems? What was the
diagnosis, prognosis, treatment and what was the
result? What medications has the horse
had, if any? For how long?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Any current health problems? What was
the diagnosis, prognosis, treatment and what was the result? What
medications is the horse on, if any? For how long?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
What is the current condition of the
horse? If sick, what are the symptoms, how extreme is the lameness, etc?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
If applicable, are there any X-rays or
other diagnostics available? ____________
Is there anything else I should know
about this horse, his condition and how he is kept, used, etc?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________