Horse Name
Horse Age
Gender GeldingMareStallion
Mares only: Is your mare: Pregnant?Lactating?
Breed
Height
Provide EITHER Weight OR Girth and Length measurements below:
Weight:
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.
Performance Requirements:
Work / Training Regime (Days / Hours and type of exercise):
Diet / Nutrition / Feed Schedule:
Living Arrangements (tick all that apply): PaddockStableYard
What specific issues would you like addressed during your herbal medicine consultations?
Current Medical Conditions:
Current Medications and Supplements:
How would you describe your horse’s: (tick as many as apply)
Skin: DryFlakyOilyInfectedNormal
Coat: DryBrittleDullThinningShaggySoftShinyFast growthSlow growth
Hooves: Fast GrowthSlow GrowthHardLaminiticDryBrittleSoftInfected
Eyes: BrightDullCloudyUlceratedWeeping / PussyBloodshotYellowBlindness
Teeth: HealthyTeeth missingLoosePlaqueSharpNever checked
Manure: NormalDryColour: Green or BrownColour: Red or BlackFood particles presentGrainy / granules present
Digestion: Good doerPoor doerStrong appetitePoor appetiteFussy eaterSmell sensitiveDrops food
Musculoskeletal: PainInflammationArthritisStrain / sprainBreak / fractureOther
Behaviour: NormalAnxiousAggressiveHormonalDull / flat
Please provide current photographs of the following below or send via email to gizelle@sacredhorse.com.au: (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):
Hooves:
Photo of specific problem for assessment:
I 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.,
Your Email
(If you have a lot of photos, please allow time for them to upload)