chariot vet consent

To comply with the veterinary surgeons’ act 1966 permission to give massage therapy must first be granted by the veterinarian the animal is register with. At this time, I (Alice Hill Aka Chariot Sports Massage) am a student of Centaur Equine Massage Therapy Training, accredited by ukruralskills, undertaking case study work to complete training.
Name
Contact number
Format: 00000000000.
Yard Address
Vet Details
name, practice and address
Horse Name
Breed
Age
Sex
Height
Colour
please check here, sign and date below that you (the owner) consent.
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To be completed by the consenting veterinary surgeon.

Client signiture may not be visable on mobile but should show on desktop.
Name of consenting veterinary surgeon
Contact phone number
Format: 00000000000 .
Email
example@example.com
Brief relevant medical history including any injury, complaint, areas of caution etc
YesNo
I confirm that the animal detailed is currently under my care and is in a fit condition to receive this therapy.

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Dated

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Date
Chariot Sports Massage, Mobile: 07885658184 email: alicechill@hotmail.co.uk
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