Health certificate

Veterinary Examination for Horses Presented for the EBT Auction

Owner: ____________________________ Date: ____________________________

Horse Identification: ____________________________
U.E.L.N.: ____________________________
Date of Birth: ____________________________

Microchip: ____________________________

Medical History: ____________________________

General Condition / Shoeing: ____________________________

Skin: ____________________________

Eyes: ____________________________

Head, Neck, Teeth (Overbite/Underbite): ____________________________

Circulatory System, Lungs, Heart: ____________________________

Reproductive Organs (Testicles Descended?): ____________________________

Musculoskeletal System: ____________________________

Back: ____________________________

Walk and Trot in Hand: ____________________________

Movements on the Circle: ____________________________

Flexion Tests:

  • left front: ________

  • left back: ________

  • right front: ________

  • right back: ________

Free Movements: ____________________________

Neurological Findings: ____________________________

Blood Sample: ____________________________

Status of Genetic Diseases (CA, SCID): ____________________________

Veterinarian: ____________________________
Date: ____________________________
Stamp: ____________________________
Signature: ____________________________