(a) Every licensed practicing veterinarian shall keep a written record of his practice concerning horses participating at pari-mutuel quarter horse race meets in this State whether performed at a licensed quarter horse track or elsewhere which shall disclose:

1. (1) the name of the horse treated;
2. (2) the nature of the horse's ailment;
3. (3) the type of treatment prescribed and performed for the horse; and
4. (4) the date and time of such treatment.

(d) The attending veterinarian shall complete and submit daily a form prescribed by the commission which will contain each horse entered to race on that day and treated by him with furosemide. The form shall also contain the following information:

1. (1) name of the track;
2. (2) name of the trainer;
3. (3) description of the horse;
4. (4) tattoo number; and

5. (5) the dose, route and time of administration.

   The form must be signed by the attending veterinarian and filed at a location designated by the commission.