Lameness History Lameness History Form Please use this form to fill out information on your horse's lameness. Date Date Format: MM slash DD slash YYYY Owner Name First Last Email Horse NameHorse's AgeHorse's GenderHorse's BreedHorse's ColorDuration of OwnershipHorse's DisciplineWhat is your primary concern?When did you first notice the problem?Was there a specific incident that led to the problem?Is it improving or getting worse?Is your horse in current work? If so, what type and how much?Does the horse work out of it?When is the problem the most obvious?Has the horse been seen by another vet? If so, what was done?Have any x-rays, ultrasounds or other diagnostics been performed?What treatments have been done? Did anything help?Is the horse on any medications? If so, when was it last given?Are there any other problems?EmailThis field is for validation purposes and should be left unchanged.