New Client Intake Form Name (Owner) * First Name Last Name Email * Phone * (###) ### #### Home Address * Barn Name & Address * Name of Vet * Name of Farrier/Trimmer & last date with horse * Name of Chiropractor/Massage Therapist/Saddle Fitter (last dates with horse) * Name of Equine Dentist (last date) * Name of Horse * Age, Breed, & Sex of Horse * Length of Ownership * Horse’s Job/Riding Discipline/Level/Frequency of Riding * Do you train with a professional/have instruction? * Show History * Turnout Details (length of time/size of area) * Access to forage (continual or timing/amount) * Grain/concentrates (type and amounts) * Current Movement or Performance Issues * Current Veterinary Issues * Past Veterinary History (including accidents or falls) * Any Metabolic or Systemic Issues (PPID, PSSM, Lyme, etc.)? * Any hoof issues/concerns? * Is your horse on any current medication? * Date of last vaccines * Do you have any specific thoughts about your horse you think may be relevant? * Your goals and aspirations with your horse * Thank you!
