To be completed and signed by the owner or person responsible for the horse

  • Please click here to see our Privacy Policy and learn how we will use and protect your data.

  • How long has the horse been at its current location?

  • Your duty of disclosure

    You must take care when answering any questions we ask by ensuring that all information provided is accurate and complete. You have a duty to disclose to us all material facts that we may rely on when setting the terms of the policy or accepting coverage.

  • If you do not tell us something

    If we establish that you have failed to comply with this duty of disclosure or provided us with incorrect or incomplete information that we have relied upon when accepting this coverage, we may refuse to pay your claim or reduce the amount payable to you. If the non-disclosure is fraudulent then we may treat your policy as if it never existed and decline all claims.

    Please email all relevant veterinary reports regarding any problems mentioned to newmarket@lycetts.co.uk
  • Please answer the following questions to the best of your knowledge and ability by ticking the appropriate box
  • If you have ticked any of the boxes in the right hand column, please complete below

    Please fill in the below box with the following information:

    • Date of Problem
    • Type of Problem
    • Treatment Details
    • Recovery Status