Test consultation form - horses

Custom Pack questionnaire for horses

We ask you to take time to fill out this form giving as much detail as possible. All information given will be confidential and treated in a non-judgemental way. Remember, this is to help your horse to thrive in a natural healthy way.
Please note that the recommendations and advise we give are for the horse detailed in the form and are not transferable to any other animal.
If you are unable to complete the form in the current session you can save your entries to complete it later - please scroll to the bottom of the page and click on the link.

Discount for additional animals
- We offer discounts for additional animals so please check the box if you would like information on discounts and we will contact you.
Name*
First Last
Address*
Address Line 1 Address Line 2 Town County / State / Region ZIP / Postal Code Country
Phone*
Email*
What is the name of your horse?*
Breed/type*
Age*
Sex*
Is your horse entire or castrated?*
How long have you owned him/her?*
Was your horse rescued/rehomed?*
Has this animal ever been or is he currently being used for breeding?*
Has this animal ever been or is she currently being used for breeding?*
Professional Services
Vet's name*
First Last
Vet's Address*
Address Line 1 Address Line 2 Town County / State / Region ZIP / Postal Code Country
When did he/she last see the vet?*
When was he/she last vaccinated?*
Please give details of vaccines if known.*
When was he/she last wormed?*
Please give details of wormers if known.*
Do you use worm counts/saliva testing?*
Have you used alternative therapies before?*
Please give details of therapies, conditions, outcomes and when they were last used*
Name of dentist*
First Last
Name of farrier*
First Last
Name of saddler*
First Last
Name of trainer*
First Last
Activities
Please give details of daily routine including excercise*
Please give details of previous exercise/competitions if known*
Please give details of previous work*
Physical condition
Are there any current medical conditions?*
Please list current medical conditions*
Is he/she currently on any medication?*
Please list all medication prescribed for current or ongoing conditions*
Are there any previous medical conditions?*
Please give details and any medications prescribed*
Feeds and Supplements
Please list everything you currently feed including supplements*
How would you describe your animal's appetite?*
How would you describe your animal's energy levels?*
Stabling and Grazing
Is your horse currently:*
Is your horse able to browse on trees and hedgerows?*
Are the fields grazed fertilised?*
Are the fields treated with herbicides?*
How many other horses does this horse share a field with?*
Is the herd mixed or single sex*
Your horse's character
Please describe your horse's character*
Are there any behavioural issues e.g. aggression, domination, spookiness, excess energy?*
Please give details*
Any other information
Please give any other information you feel is appropriate or may be useful, including any aims you may have
Finally, please outline how you would like to help your animal, and what changes would you like to make.*
Comments
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Custom Pack questionnaire for horses

Professional Services

Activities

Physical condition

Feeds and Supplements

Stabling and Grazing

Your horse's character

Any other information