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New Client Intake Form

Please complete the following intake form to the best of your ability and knowledge for the horse receiving services. If you have multiple horses that will be receiving services, please complete a new form for each horse.  

 

If you have any questions, please reach out. 

Phone:

705-305-0179

Email:

Social Media

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Horse Information

I AM ALLOWING ELEVATED EQUINE MASSAGE AND ALL PERSONS CORRELATED TO THE COMPANY TO ASSESS, TREAT AND CUSTOMIZE A PROGRAM FOR MY HORSE. I AGREE TO HOLD THEM HARMLESS FOR ALL INCIDENTS THAT MAY OCCUR DURING THE TIME ELEVATED EQUINE MASSAGE IS PRESENT, OR DURING THE TIME I AM CARRYING OUT THE ASSIGNED PROGRAM.

I AGREE TO SEEK VETERINARIAN ADVICE FOR ANY APPLICABLE CIRCUMSTANCES OR SCENARIOS, AND UNDERSTAND THAT ELEVATED EQUINE MASSAGE'S ADVICE AND SERVICES DO NOT REPLACE VETERINARY CARE AND ARE NOT CONFIRMED DIAGNOSES OF ANY INJURY OR CONDITIONS

I AGREE TO ALLOW ELEVATED EQUINE MASSAGE TO TAKE PICTURES AND VIDEOS OF MY HORSE AS A METHOD OF MAINTAINING RECORDS BUT I ALSO UNDERSTAND THAT THE PICTURES AND VIDEOS MAY BE SHARED FOR PROMOTIONAL PURPOSES. 

Thanks for submitting!

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