Ginger Krantz Equine Healing
Energy Healing
Contact
Equine Intake Form
Owner's Name
*
First
Last
Name of Horse
*
Breed
*
Age
*
Actual
Estimate
Date or Year of Birth
*
Sex
*
Gelding
Mare/Filly
Stallion/Colt
Date of Acquisition
*
Where did you obtain your horse from?
*
Please tell me about your horse's prior history of use, if known:
*
Daily Feed and Hay
*
Grain: quantity and type. Pelleted or Premixed Feed: quantity and name. Hay: quantity.
Daily Supplements and Herbs
*
Current Veterinary Diagnosis
*
Please also include any historic veterinary diagnosis you feel are important.
Current Medications Your Horse is Taking
*
Also include what each medication is for and the prescribed duration of time.
Vaccination History
*
Medical History: Colic, Surgery, Illness, etc.
*
Any Behavior Problems?
*
Any Lameness, Injuries or Accidents?
*
Historic and present.
Worming Routine
*
Do you run fecals on your horse?
Hoofcare
*
Shod
Barefoot
Your Horse's Turn-out Schedule
*
On grass or dirt paddock?
How can I help you and your horse?
*
We will speak in greater detail on the phone, but please give me a general idea what is going on physically and/or emotionally with your horse that you would like to address in the healing.
Submit
All the fields marked with a red asterisk are required in order to submit the form.
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