Veterinary Inspection Form
Certificate of Veterinary Inspection
All horses must have a satisfactory Certificate of Veterinary Inspection (CVI) completed within 14 days of the event AND proof of a current (within 6 months) rhinopneumonitis vaccination to compete at the 2023 Montana 4-H State Horse Show.
Other vaccinations recommended are Eastern/ Western Equine Encephalomyelitis, Tetanus, Influenza, Rabies, and West Nile. ONE CVI PER HORSE.
Montana State 4-H Horse Show
The Cottonwood Equine Center 11 CC Lane Joliet, MT 59041 September 22-24, 2023
Each horse must be inspected at home/locally. There will NOT be a veterinarian on the grounds to perform on-site inspections. Please present this Certificate of Veterinary Inspection at event check-in before unloading. Show committee reserves the right to refuse entry to suspect animals at check-in or require removal of suspect animals during the event.
Owner's Information ___________________________________________________________________________________________________
Address _________________________________________________________________________________________________________________
City __________________________________________________State _______________________________ Zip __________________________
Horse's Name (Registered and/or Common) ___________________________________________________________________________
Age of Horse _________________________ Sex of Horse _________________________Breed of Horse __________________________
Horse Color __________________________
Vaccination History
Vaccination | Administered? | Note date administered, lot number if available, and who administered) |
---|---|---|
Rhinopneumonitis | Y / N | |
West Nile | Y / N | |
Influenza | Y / N | |
Eastern/Western Equine Encephalomyelitis | Y / N | |
Rabies | Y / N | |
Tetanus | Y / N |
Veterinary Inspection
Temperature _________________ Pulse _________________ Respiration Rate ______________________
Lymph nodes normal? Yes No
Nasal discharge? Yes No
Additional findings: _____________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
I, (name) ______________________________________, DVM, have examined the horse named above for signs of disease on (day/time) ___________________________________________________________________.
I find this horse to be free from visible signs of infectious disease.
Signature: __________________________________________________________