EHV Return to Competition

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USEF EHV-1 Return to Competition Declaration and Testing Result Form

I, as the owner/trainer/agent, declare that my horse , with the USEF horse ID :

Has been quarantined for at least 14 days following departure from grounds on .

Has not been on any premise that is, or has been, under quarantine by the California Department of Food and Agriculture (CDFA) within the last 14 days

The horse above has not been exposed to a horse with a confirmed positive diagnosis of EHV-1 Or EHM within the last 14 days

The horse above has completed a day quarantine. For 28 day quarantine no nasal swabs are required, for a 21 day quarantine 1 nasal swab is required, and for a 14 day quarantine 2 nasal swabs are required. (Day 0 being the day of departure from the restricted premises)

First nasal swab was collected, for the horse above, on the following day and sent to .

Below please provide a PDF or JPG copy of the test results:
Second nasal swab was collected, for the horse above, on the following day and sent to .

Below please provide a PDF or JPG copy of the test results:

Quarantine Address

Veterinarian

Veterinarian Email

Veterinarian Phone

Trainer/Owner/Agent Responsible for the truthfulness and accuracy of the aforementioned information

Signature

Signed Date 11/22/2024

Contact Name

Contact Email