• USPA Equine Vision Report Form

  • Required by USPA Outdoor Rule 5b and Arena Rule 2b for any player who intends to play a mount in goggles or protective eyewear or a mount which exhibits any likelihood of having impaired vision: Effective January 1, 2026. A mount with no vision in one or both eyes may not be played in any USPA Event.

  • Format: (000) 000-0000.

  • Veterinary Certification (Required)

  • I certify that I am a licensed equine veterinarian and that I have personally examined the above-named mount.
  • Date of Examination:
     - -
  • Signed at: 2026-01-09 16:05:55
  • Date:
     - -
  • Signed at: 2026-01-09 16:05:55

  • Player Certification & Acknowledgment

  • I certify that:
    • This Vision Report Form has been truthfully completed and filed with the USPA at least 24 hours prior to the Event.
    • I understand that falsely confirming compliance may result in a Conduct Violation Complaint.
    • I understand that failure to confirm filing of this form may result in removal of the mount and issuance of a red card, with subsequent violations subject to further discipline.
    • I understand that the certification is only valid for 90 days from the date it is signed by the veterinarian.
  • Image field 29
  • Signed at: 2026-01-09 16:05:55
  • Date:
     - -

  • Submission Instructions

  • This completed form must be submitted no later than 24 hours prior to the Event to: The Host Tournament Committee and equinewelfare@uspolo.org
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  • Should be Empty: