New Client Information Form

Name of Owner *

Barn Name *

Phone *

Barn Address *

E-mail *

Horse's Name *

Breed *

Color *

Date of Birth *

Sex *

Height (hands) *

Weight (lbs) *

When purchased? *

Current Veterinarian *

Vet Phone *

Vet Address *

Vet E-mail *

Name of Farrier *

Farrier Phone *

Farrier Address *

Any notable present or past health issues, injuries, surgeries, or behavioral concerns? Have they been resolved? *

Other equine healthcare professional(s)? *

Behavioral concerns (nipping, aggression, cribbing, stall aggression, etc.)? *

Last vet visit & why? *

Last shod/trimmed? *

Teeth last addressed & by whom? *

Ever had a massage? *

Saddle/tack last fitted? *

Ridden in another saddle? *

Current feeding program (incl. medications/supplements) *

Housing (stall, turn out, etc.) *

Current discipline(s) trained, and previous training in others? *

Areas currently sore/tight? *

Bites, kicks, cross-tie issues, hoof handling, other vices? *

Other Comments

Signature *