HORSE INTAKE QUESTIONNAIRE

THE GOLD STANDARD IN THOROUGHBRED RESCHOOUNG
HORSE INTAKE QUESTIONNAIRE
By answering these questions to the best of your ability, you help our team place these horses in the most suitable long-term homes and effectively schedule necessary procedures.

*Horses must have current negative Coggins & Health Certificate for entrance into Kentucky Horse Park & Secretariat Center*
Horse's Jockey Club name
Please list dates of all current VACCINATIONS: (FluRhino, EIW, Encephalitis, Rabies,Tetanus, West Nile, Botulism)
Please list dates of most current DEWORMING:

MonthDayYear
Date
CASTRATION DATE

MonthDayYear
Date
Last Ridden:
Please list any Stable Vices:
PAST INJURIES SURGERIES OR PROCEDURES TO NOTE
ANY PARTICULAR IDIOSYNCRASIES UNDER SADDLE SENSITIVITIES OR ALLERGIES TO NOTE
IF A MARE HAVE THEY EVER HAD ANY FOALS
*If applicable*

Please RELEASE or provide copies of all vet reports and/or radiographs, ultrasounds, etc. to the Secretariat Center. Programs@secretariatcenter.org 4155 Walt Robertson Rd Lexington, KY 40511 (859) 246-3080
Should be Empty: