Rogue Equine & Companion Animal Clinic

for compassionate, personalized, expert veterinary medical care
serving Southern Oregon and Northern California.

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Health Certificate Form

You are here: Home / Forms / Health Certificate Form

Health Certificate Form - Equine

This completed form is required by law in order for us to provide service. This information is kept secure, private and will not be shared with any 3rd party without your expressed consent. Please use "Coggins and Health Certificate Form" if a Coggins/EIA test is required to be run.
  • Agent Information

    If you indicate yes, please complete the following sections. Otherwise please skip to the owner section.
  • Owner Information/Consignor

  • Horse Information

  • Examples include star, right hind sock, left hind pastern (white), brand description, etc.
  • MM slash DD slash YYYY
  • NameBreedSexAgeColorMarkings 
  • Destination Information for Health Certificate or "CVI"

  • MM slash DD slash YYYY
  • Please list yourself if you are hauling.
  • Must have physical address. If show grounds, the city, state and name of show grounds is adequate.
  • This field is for validation purposes and should be left unchanged.
Save and Continue Later

Services

  • Reproduction
  • Surgery
  • Imaging
  • Sports Medicine
  • CEM Quarantine
  • Telemedicine

Preventive Care

  • Dentistry
  • Wellness Program
  • Immunizations
  • Deworming

Complementary Medicine

  • Chiropractic
  • Acupuncture

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Contact Us

Hours of Operation
Mon-Fri: 8:00 A.M. to 5:00 P.M.
Saturday: By Appointment Only
Sunday: Closed

Address:
14099 Highway 62
Eagle Point, Oregon 97524

Phone: 541-826-9001
IMessage: rogue@rveh.com
Fax: 541-826-1099
Email: office@rogueequine.com

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Hours & Info

14099 Highway 62
Eagle Point, OR 97524
541.826.9001
office@rveh.com
M-F 8AM to 5 PM
© 2018 Rogue Equine Hospital. All rights reserved.
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