USEF Medication Report Form

EHV-1 USEF Return to Competition Declaration Forms and Requirements

View

Please be aware that we are currently experiencing significant delays in receiving mail and packages, including delayed receipt of items that have already been updated as delivered by the shipping vendor.

Latest COVID-19 Updates from US Equestrian can be found on the Coronavirus Disease Resources and Updates page.

USEF Medication Report Form

Competition Search

State

Month

Identification of Horse / Pony

Enter a Horse ID to autofill

Name

Age

Gender

Color

Weight

Entry #

Trainer

Owner

Breed / Discipline

Microchip

Prescribing Veterinarian and Administration Contact Information

Veterinarian

Veterinarian Email

Veterinarian Phone

Diagnosis

Flunixin administered?

Person Administering

Contact Email

I would like to be considered for a Pergolide Therapeutic Use Exemption

Identification of Medication

Medication Name

Amount

Strength

Administration Route

Administration Method

Administration Date

Administration Time

No Medications Identified

Create