4741-1-21 Record keeping.

(A) Every veterinarian performing any act requiring a license pursuant to the provisions of Chapter 4741. of the Revised Code shall prepare, or cause to be prepared, a record documenting the health status of the animal(s) treated and any necessary data such that another veterinarian may follow the rationale and continue therapy if necessary. The record shall be dated and shall include all pertinent medical data such as vaccination, drug types and doses and all relevant medical and surgical procedures performed, including anesthesia monitoring. The records shall identify the owner of the animal(s) and provide an address and telephone number or other means of contact.

(B) Records for companion animals shall include identifying information such as age, sex, species and breed or description and the animal's name, if known. Animals used for economic purposes that are treated on an individual basis shall be similarly identified. Animals used for economic purposes that are treated on a herd basis may be identified collectively, provided the treatment information is reflective of accepted medical practice for the species and lists doses of all drugs dispensed and administered.

(C) All regulated substances shall be recorded as required by federal and/or state regulations.

(D) Records, including imagery, diagnostic tests, laboratory data, surgery reports, progression of the disease process and other pertinent information, shall be maintained by the treating practice. Records shall be released upon request from a treating veterinarian and must be returned to the originating practice within a reasonable time. Copies of records must be available upon request from the owner of an animal at a reasonable cost to the owner.

(E) Records shall be kept for a period of three years following discharge of the animals(s) from veterinary care.

Effective: 07/15/2014
R.C. 119.032 review dates: 03/04/2014 and 03/01/2019
Promulgated Under: 119.03
Statutory Authority: 4741.03(C)(9)
Rule Amplifies: 4741.22(Y)
Prior Effective Dates: 01/22/2003, 11/15/2007, 10/15/2012