Consent and Acknowledgement to Therapy

I have read and understand the below disclosure statement in regard to the therapy to be given to my animal(s)animal names* by Release Equine Therapy LLC.

I understand that this person is not a veterinarian, that the therapy given is not to be considered as veterinary treatment, and that comments, suggestions, or recommendations proffered in the course of this therapy are not to be construed as veterinary medical advice. Massage/touch therapy and other holistic modalities are not a substitute for veterinary medical care, but rather they are a cooperative form of therapy.

I, owner or agent of owner* wish to have this therapy for my animal(s) and give my consent and acknowledgment by signing below, in compliance with the Colorado Veterinary Practice Act.

I, owner or agent of owner* certify that my animal has received regular veterinary care and vaccinations, as needed.

By signing this form, I acknowledge that I have read and fully understand the previous statements and consent to Release Equine Therapy LLC performing massage and/or acupressure on my animal. I understand that I am waiving any and all claims that I may have against Release Equine Therapy LLC.

Email

example@example.com

Signed Date

Date

Owner/Guardian Name

First NameLast Name

Signature

Consent and Acknowledgement to Therapy

Statement of Disclosure