Bodywork
Clients

Fill out your new client intake form here & we will be in touch with you shortly

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Training
Clients

Fill out your new client intake form here & we will be in touch with you shortly

Start Now

New Bodywork Client Intake Form

Please fill out the following form to the best of your abilities & we will be in touch with you shortly!

First name

Last name

Owner's Home Address

Horse's Name

Horse's Age

Horse's Breed

Horse's Sex

If Horse Is A Mare, Could She Be Pregant?

Barn Address

Describe Your Horse's Personality

What Discipline Is This Horse Used For? (If Applicable)

Horse's Execise Schedule (If Applicable)

Light Work (1-2 x/week)

Moderate Work (3-4 x/week)

Heavy work (5+x/week)

Describe Your Horse's Current Exercise Routine (Optional)

Describe Your Horse's Health History (Injuries, Surgeries, Chronic Conditions, etc.)

What Is Your Horse's Diet? (Including Any Supplements)

Horse's Turnout Schedule

Stalled 24/7

1-4 Hours Turnout

5-9 Hours Turnout

10-14 Hours Turnout

15-19 Hours Turnout

Turned out 24/7

Name of Vet

Name of Farrier

Horse's Trim/Reset Cycle

1-2 weeks

3-4 weeks

5-6 weeks

7-8 weeks

8+ weeks

Is Horse Shod?

Shod in front

Shod all around

Barefoot

Has This Horse Recieved Bodywork Before?

Yes

Name of Other Bodywork Practitioners (Chiro, Massage, Osteo, PEMF etc.)

Name of Horse's Dentist

Date of Horse's Last Dental

What Are Your Goals For Your Horse's Session?

Additional Notes/Comments/Questions:

Owner Consent: I give consent for the Equibow Technique to be performed on my horse

Yes

Owner Consent: I understand that the Equibow technique does not in any way replace veterinary diagnosis or care

Yes

Your Signature

New Training Client Intake Form

Please fill out the following form to the best of your abilities & we will be in touch with you shortly!

First name

Last name

Owner's Home Address

Horse's Age

Horse's Sex

Horse's Name

Horse's Breed

If Horse Is A Mare, Could She Be Pregnant?

Barn Address

Describe Your Horse's Personality

Describe Your Training Goals For Your Horse

Describe Any Behaviour Challenges That Your Horse Is Exhibiting (biting, bolting, separation anxiety, etc.)

Do You Have Any Experience With R+/Clicker Training

Yes - My horse & I have already begun using R+

Yes - I have used it with dogs but not my horse

What Discipline Is This Horse Used For? (If Applicable)

Horse's Execise Schedule (If Applicable)

Light Work (1-2 x/week)

Moderate Work (3-4 x/week)

Heavy work (5+x/week)

What Is Your Horse's Diet? (Including Any Supplements)

Horse's Turnout Schedule

Stalled 24/7

1-3 Hours Turnout

Half Day Turnout

Turned out 24/7

When Turned Out, Does Your Horse Live With Other Equines?

Yes

Name of Vet

Name of Farrier

Horse's Trim/Reset Cycle

1-2 weeks

3-4 weeks

5-6 weeks

7-8 weeks

8+ weeks

Is Horse Shod?

Shod in front

Shod all around

Barefoot

Has This Horse Recieved Bodywork Before?

Yes

Name of Bodywork Practitioners (Chiro, Massage, Osteo, PEMF etc.)

Name of Horse's Dentist

Date of Horse's Last Dental

Describe Your Horse's Health History (Injuries, Surgeries, Chronic Conditions, etc.)

Additional Notes/Comments/Questions:

Owner Consent: I give consent for Evergreen Equine to apply and advise on positive reinforcemet based training techniques for my horse

Yes

Owner Consent: I understand that the advice given by Evergreen Equine does not in any way replace veterinary diagnosis or care

Yes

Your Signature

Bodywork Clients

Training Clients

New Bodywork Client Intake Form

New Training Client Intake Form

Bodywork
Clients

Training
Clients