Client Intake Form Client Equine Intake Form Date:* Date of form completionName:* First Last Email:* Enter Email Confirm Email Phone:Vet's Name:Reason for interest in bodywork:HORSE INFO: Name:*Age of Horse:*Breed:*Gender*MaleFemailBarn Address:Notable Long - or - Short term health issues, injuries, or behavioral concerns. Have they been resolved?Current feeding regimen:Describe your horse's housing (stall, turnout):Date teeth last floated: Name of farrier and where in cycle:Date of last vaccines: Were there any reactions?Horse's discipline:Use of horse and number of days per week:Number of riders:Are there multiple types of tack used? Check all that apply. Saddle Bridles Bits Use only one of each Is there anything else you feel is relevant to share about this horse?Who referred you to Major's Horse Massage? Please remember that massage is not an alternative to proper veterinary care.