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):

    Why are you seeking a Nutrition Consult for your horse?

    List ALL 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:


    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.

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