HORSE UPDATE
The purpose of this form is to update our records for a patient.
Email address *
NAME *
Please enter your name
Your answer
HORSE NAME *
Your answer
If the horse received treatment please mark the clinical response you saw at the end of the treatment.
No improvement
Improved at least one grade in Gait Score
Significant improvment
100% normal
No follow-up exam
Orogin
NeuroQuel
Marquis
Protazil
ReBalance
Compound treatment
Not Treated
If the treatment was completed at least 30 days ago, please indicate how the horse is doing.
This question is to determine long term outcome of the treatment. You may select a response for each time period.
No clinical signs
Mild clinical signs, horse usable
Clinical signs compromise use
Horse was euthanized
30-90 days post treatment
90-180 days post treatment
Six months to 1 year
Longer than a year ago
Did you notice any unusual responses while the horse was treated?
Please check each unusual behavior you noticed while the horse was getting medication.
If you chose, provide any other information here.
Your answer
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