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EQUINExtion Functional Health Care Pre-consult Questionnaire

Detailed information about your horse to help us help you.

This questionnaire takes 20-30 minutes to complete. And feel free to write as much as you like. The more information, the more effective your session can be. Note: each field requires an entry before you can proceed. You can use n/a if necessary.

Click the button below to start.

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Question 1 of 24

Name and general location

Question 2 of 24

horse's name

sex

age

height

weight

breed

Question 3 of 24

DIET : hay - type, amount, schedule

Question 4 of 24

DIET : pasture - type, amount, schedule

Question 5 of 24

DIET : processed feeds - type, amount, schedule

Question 6 of 24

DIET : grain - type, amount, schedule

Question 7 of 24

DIET : minerals - type, amount, schedule

Question 8 of 24

DIET : salts - type, amount, schedule

Question 9 of 24

TURNOUT : size of area

Question 10 of 24

TURNOUT : number of friends

Question 11 of 24

TURNOUT : type of footing

Question 12 of 24

TURNOUT : manure management

Question 13 of 24

MOVEMENT : daily amount of natural activity, daily amount and type of human activated activity

Question 14 of 24

Trimming schedule (include when last trimmed)

Question 15 of 24

Was this horse ever shod and for how long?

Question 16 of 24

The current trimmer is:

A

myself

B

a barefoot trimmer

C

a farrier

D

both barefoot trimmer/farrier

Question 17 of 24

Health history: vaccinations - type - schedule

Question 18 of 24

Health history: dewormers - type - schedule

Question 19 of 24

Health history: dental work - type - schedule

Question 20 of 24

Health history: does it include any of the following? Try to include when.  Colic, abscesses, injuries, laminitis, founder, Cushings, IR horse?

Question 21 of 24

Brief history of this horse: (ex: got as a rescue, malnourished, had horse from birth, no idea where horse has been, etc.)

Question 22 of 24

Work history: what was this horse’s previous “job”?

Question 23 of 24

What does this horse do now?

Question 24 of 24

What are your plans for this horse?

Confirm and Submit