Injury Reporting Form
Maryland private racetrack veterinarians shall complete the form below for any horses injured during racing or training activities at Laurel Park, Pimlico or Timonium. Any questions, please contact Maryland Racing Commission Executive J. Michael Hopkins, mike.hopkins@maryland.gov; 410.428.2391. Data is strictly confidential.
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Trainer's Name: *
Horse Name:
Rider's Name:
Age:
Sex: *
Track: *
Surface
Date Of Injury: *
MM
/
DD
/
YYYY
Time Of Injury:
Time
:
Location On Track: *
Track Condition:
Injury Occurred While: *
Vet's Name: *
Type Of Injury: *
Location Of Injury *
Occurrence *
Were Diagnostics Performed? *
If Yes, Which Diagnostics Were Performed?
Treatment Plan: *
Other Comments / Commentary On Track:
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