Worm Care Package Form

Select a surgery:

Horse's Name:

Client's Name:

First line of address:

City/Town:

Postcode:

Email Address:

Horse's Age:

Weight of Horse:

Body Condition Score:

From 1 (thin) to 5 (obese) - be honest!

Is your horse pregnant?:

When did you last worm your horse?:

What was your horse last wormed with?:

What dose / weight did you administer?:

Historically, has your horse been wormed:

Does your horse share it's paddock?:

How many horses share the same paddock and what size is the paddock?:

How many of the horses are under 4 years old?:

Do you rotate and rest paddocks for at least 3 months:

Do you chain harrow your paddocks?:

How often do you poo pick?:

Any other information you feel may be beneficial:

Security Question:

I have read and agreed to the privacy notice:

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