I declare that the horse(s) listed below has been in good health with no sign of infectious disease, and has not had a fever above 101.5° within the last 14 days.
I declare that the horse(s) listed below have not been on the grounds of, or at a private facility, barn, stable, or veterinary clinic that has or had an active EHV-1 or EHM positive case within the last 14 days.
I declare that the horse(s) listed below have not been in contact with a horse that has tested positive for EHV-1 or EHM within the last 14 days