Client History Form

    Horse Name

    Horse Age


    Mares only: Is your mare:



    Provide EITHER Weight OR Girth and Length measurements below:


    OR Girth:

    AND Length:

    See Guide for measuring Girth and Length

    Measurement Instructions –
    GIRTH: With the horse breathing out, position the measuring tape behind the point of the elbow and encircle around the chest behind the withers.
    LENGTH: Measure from the point of the shoulder to the point of the buttock (the most rounded point). Ensure that the measuring tape is taut and straight.

    Diet / Nutrition / Feed Schedule:

    Living Arrangements (tick all that apply):

    What are the main physical, behavioural and/or mental/emotional issues that you want addressed?

    Please List ALL Other Medical Conditions:

    Current Medications and Supplements:

    Please provide current photographs of the following below or send via email to
    (There is a limit of 8mb per file to upload and only jpg, jpeg, png & pdf fill types can be accepted)

    Full side shot:

    Photo from behind:

    Face (close up):


    Photo of specific problem for assessment (if applicable):


    confirm that I have disclosed all of my horses’ known medical conditions and answered all questions honestly and to the best of my ability. I agree to keep the practitioner informed of any changes to my horses’ medical status and understand that there shall be no liability on the part of the practitioner should I fail to do so.

    I understand that whilst every effort is made to prescribe herbs that are appropriate for use in competition, it is my responsibility to check for banned substances with my sporting association, as rules may differ between the various horse sports.

    (If you have a lot of photos, please allow time for them to upload)