Coggins Form Information:
Thank you for allowing us to handle your Coggins test this year. Not only has the state continued to mandate this test for any horse traveling within Michigan, but they have also become more stringent about having accurate and specific information on the paperwork.
To ensure the accuracy of you paperwork, please print the attached page off your browser, fill it out and have it ready for the veterinarian at the time of your appointment. It is important that all areas be filled out completely. Once the blood has been submitted to the state, there will be an additional fee to make changes to the form.
| Doctor Name: | - | Doctor coming out for appointment (if known/confirm at appt). |
| Date: | - | Date of appointment |
| Exposure No. | - | To be filled out by office. |
| Owner’s Address: | - | Complete mailing address of owner. |
| Stable Name: | - | Include name and address of where the horse is currently stabled. |
| E-Mail Address: | - | VERY IMPORTANT – We will need this for each owner in order to access the coggins and print them out. Coggins will no longer be mailed by the lab. After the results have been posted by the lab, you will be able to access your account through Global Vet Link. In order to do this your email address is necessary. If you are not able to access the internet – please let the doctor know at the time of the blood draw, so that we may make special arrangements for you to receive your coggins. |
| Horse Name/Lot Number: | - | Registered name and registration number. |
| Barn Name: | - | Barn name |
| Breed: | - | Circle Registered Breed or select “Other” and write in breed name. |
| Sex: | - | Circle one |
| Color: | - | Circle correct color or select “Other” and write color in. Paint owners please indicate Tobiano or Overo. |
| DOB/Age: | - | Age or date of birth – If age is written in years, the horses birth date will default to January 1, of the year they were born. |
| Markings: | - | Please indicate any white markings. |
Kern Road Veterinary Clinic 105 Fowlerville Road
Fowlerville, MI 48836
Tel: 517.223.9618
Fax: 517.223.0101
- Mon. 8:00 am - 7:00 pm
- Tue. 8:00 am - 5:00 pm
- Wed. 8:00 am - 7:00 pm
- Thu. 8:00 am - 5:00 pm
- Fri. 8:00 am - 5:00 pm
- Sat. 8:00 am - 12:00 pm
- Sun. Closed