Polyneuritis equi (PNE) evaluation form for inclusion in Study 219-FE-3.7.1
Horse Owner Contact Information:
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Email *
Owner Name: *
Horse Name: *
Horse's weight *
Horse's age breed, and sex: *
Please enter the age of your horse, the breed, and if it is a mare, gelding, or stallion
Address *
Date: *
MM
/
DD
/
YYYY
Veterinarian Name: *
Vet Email: *
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