WORMING PROGRAMME

Name *

Prefix First Name Last Name
E-mail
Are you a registered client of New Forest Equine Vets? *

Yes No

Address

House No: or Name
Street Address
City	County
Post Code	Country

Phone

- Area Code Phone Number
Mobile *

HERD INFORMATION
Total number of animals in herd
Any Donkeys?

Yes No
Any sheep/cattle co-grazing?

Yes No
Stocking density (number of animals per acre)
Stocking density (number of animals per acre)

Less than one one More than one

WORMING PRIORITIES

Priorities for your worming programme (select all that apply)
Minimal Drug Use Reduce Risk of Wormer Resistance Most Environmentally Friendly Cost Ease of administration
Any other comments?
Should be Empty: