Barrier Cream Field Study
(horses)

Application form (Print version)

Owner details

1    Name:

2    Address + postcode:

 

 

3    Email:

4    Telephone:

 

Horse details

1    Breed: …..

2    Gender: (male/female)*

3    Neutered (yes/no)*

4    Age (months):

5    Diet:



 

6    Allergies:



 

7    Describe in your own words (or your vets) your animal's patient history and current condition
(e.g. what happened/diagnosis/surgery/problems/treatments, current state).



 

 

 

 

 

 

“I agree to send an update on my pet’s condition (including photo) 2-4 week after receipt of my samples” (yes/no)*
”I agree to my pet’s details being used (anonymously) for research/publication purposes by the University of Lincoln” (yes/no)*

8  (* delete as appropriate)

 

 

Send to:

Frank Ruedisueli

University of Lincoln

Department of Biological Sciences

Riseholme Hall

Lincoln, LN2 2LG

U.K