Appendix C. COMMONWEALTH OF PENNSLVANIA STATE HARNESS RACING COMMISSION 2301 North Cameron Street Harrisburg, Pennsylvania VETERINARY HEALTH CERTIFICATE FOR STANDARDBRED HORSE

THIS CERTIFICATE MUST ACCOMPANY THE HORSE DESCRIBED FOR ADMITTANCE TO A PENNSYLVANIA PARA-MUTUEL HARNESS RACING TRACK.

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Name of HorseTattoo NumberAgeSex

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Owner’s NameTrainer’s Name

I hereby certify that I have examined the above described horse on

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and have found no clinical evidence of infectious, (date)
contagious, or transmissible disease and that it was afebrile and free of ectoparasites at the time of this examination. To the best of my knowledge this horse has not been exposed to other horses with any infectious, contagious, or transmissible diseases within the past two weeks.
Horse’s Temperature
At Time of Examination

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Veterinarian’s Signature

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Veterinarian’s State License Number

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Address

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Date Issued

AN INDIVIDUAL FORM MUST BE ISSUED FOR EACH HORSE. FORMS AVAILABLE AT ALL LICENSED ASSOCIATION AND COMMISSION OFFICES.