Please fill out the form below or print, fill out, and send the following pdf: Admission Form for Elective Procedures and Outpatients PDF

Hospital Admittance Form
Fairfield Equine Associates
32 Barnabas Road
Newtown, Connecticut 06470
(203) 270-3600 (Office) ~ (203) 270-4671 (Hospital) ~ (203) 270-4660 (Fax)

In an effort to protect the health of horses cared for by our clinic and that of the horses with which they
associate, Fairfield Equine Associates has the following requirements for horses coming to our hospital for
elective or outpatient procedures:

1. There is no evidence of a contagious disease where the horse is regularly stabled.

2. A temperature log for the 72 hours (3 days) immediately prior to the appointment must be
presented with the horse on admittance. The temperature must be recorded every 12 hours. If the
horse has had a temperature greater than 101 degrees Fahrenheit or an increase in temperature of
greater than 2 degrees at any time during this 72 hour time period, please call us for further
instructions. (*)

3. The horse must have received a rhinopneumonitis vaccine between 7 and 90 days prior to the

4. A negative Coggins form dated within 1 year must be provided.
5. When appropriate, clients must bring their own tack so that horses may be evaluated with a rider.
Fairfield Equine Associates will not provide tack to be used by multiple horses.

We believe these requirements are needed to ensure the safety of our patients and the access of our facility
to the equine community. We greatly appreciate your efforts and compliance.

Rhinopneumonitis (EHV-1/4) Vaccine History
Coggins Test