Veterinary Practice Regulations 2022

A veterinarian must —

make a clinical record in accordance with subregulation (4) if the veterinarian —

carries out an act of veterinary medicine; or

supervises a veterinary student or veterinary nurse student who is carrying out an act of veterinary medicine;

either —

if the act is carried out as part of a veterinary practice business and the veterinarian is not a practice owner of the business — give the record to a practice owner of the business; or

otherwise — keep the record for the period of 7 years beginning on the day on which the record is made.

A veterinary nurse must —

make a clinical record in accordance with subregulation (4) if the veterinary nurse carries out an act of veterinary medicine; and

either —

if the act is carried out as part of a veterinary practice business and the veterinary nurse is not a practice owner of the business — give the record to a practice owner of the business; or

otherwise — keep the record for the period of 7 years beginning on the day on which the record is made.

An authorised person, other than a veterinary student or a veterinary nurse student, must —

make a clinical record in accordance with subregulation (4) if the person carries out an act of veterinary medicine; and

either —

if the act is carried out as part of a veterinary practice business and the authorised person is not a practice owner of the business — give the record to a practice owner of the business; or

otherwise — keep the record for the period of 7 years beginning on the day on which the record is made.

The clinical record must —

be made at the time, or as soon as practicable after, the person carries out the act of veterinary medicine; and

be in writing and be legible; and

contain the following details in relation to the act —

the name and title of the person who carries out the act;

if the act is carried out under supervision — the name and title of the person providing the supervision;

the name and address of the person in charge of the animal;

the species, breed and sex of the animal;

the age and weight of the animal, or, if not known, the estimated age and weight;

sufficient details to identify the animal, including any microchip number or other identifying particulars;

the relevant clinical history of, and any other relevant details about, the animal;

if the act is carried out under a treatment plan — details of the plan;

the day on which the act is carried out;

the day on which the record is made;

contain any other details relevant to the act, including the following, if applicable —

the details and results of any examinations and procedures carried out on the animal;

the details and results of any imaging, or diagnostic or laboratory tests, carried out on the animal;

any provisional, differential or definitive diagnosis;

the name, dosage, route of administration, duration of treatment prescribed, quantity and strength of any poison prescribed, supplied or administered, and the name and title of the person who prescribed, supplied or administered the poison.

A person who alters a clinical record must —

clearly identify the alteration on the record; and

state the person’s name and title, and the day on which the alteration is made, on the record.

A practice owner to whom a clinical record is given under subregulation (1)(b)(i), (2)(b)(i) or (3)(b)(i) must ensure that the clinical record is kept for the period of 7 years beginning on the day on which the record is made.

A person does not commit an offence under subregulation (1), (2), (3) or (6) if —

another person complies with the requirements of the provision in relation to the act of veterinary medicine; or

otherwise — the person has an honest and reasonable belief that another person has complied with the requirements of the provision in relation to the act of veterinary medicine.