Consultation Form

Instructions: Fill out all parts of application as completely as you can.
After your application has been thoroughly reviewed I will notify you via email.
The questions in the form are preliminary. Once we begin the consult,
I will most likely have additional questions that I will ask via email.

* Your name:

* City and State (If outside the U.S. enter your country)

* Email address

THE FOLLOWING QUESTIONS ARE ABOUT YOUR HORSE

Horse's Name

Age

Breed

Gender

What is the problem for which you are seeking a consultation?

What have you already done to try and address this problem?

Have any diagnostics or tests been done on this horse? For example: x-Rays, or lab work
If yes, please list what was done and when.

Has a veterinarian given you a diagnosis of the problem?
Example: founder, navicular, Cushings, etc. If yes, what treatment was recommended?

Describe your horse's diet. Be very detailed. Include all supplements, brand of feed, how much is fed and how often each day. Include how much and what type of hay is given each day.

Describe your horse's lifestyle and environment. For example: Amount of turnout each day. Amount of stall time. Surface of turnout area - e.g . grass pasture, dirt paddock, rocky, sandy, etc.

Describe your horses activity, e.g., type of work, what discipline, frequency of work/exercise, etc.

* Describe your horse's vaccination/worming routine, including the date(s) most recently given.

Has your horse had any other health or soundness issues prior to the issue of this consult?

Additional comments or information you would like me to know.

Enter your email address to receive a copy of this form along with your answers.

* Indicates Response Required

Consultation Form

Instructions: Fill out all parts of application as completely as you can. After your application has been thoroughly reviewed I will notify you via email. The questions in the form are preliminary. Once we begin the consult, I will most likely have additional questions that I will ask via email.

THE FOLLOWING QUESTIONS ARE ABOUT YOUR HORSE

Instructions: Fill out all parts of application as completely as you can.
After your application has been thoroughly reviewed I will notify you via email.
The questions in the form are preliminary. Once we begin the consult,
I will most likely have additional questions that I will ask via email.