Small Animal PEMF

Small Animal PEMF — EN

Henlea Equine Wellness
Owner/ Guardian Information:
Full name*
Phone number*
Email address*
example@example.com
How did you hear about Henlea?
Would you like to hop on the email list to receive exclusive offers and first access to deals?

YesNo
Animal Information:
What type of animal are you scheduling PEMF sessions for?*

DogCatOther
Name*
Age*
Breed
Veterinarian/Clinic*
Has your animal ever had a PEMF session before?*

YesNo
If yes, when was the last time?
What wellness goals are you hoping to achieve with PEMF?*
Does your animal receive any other therapies or modalities? Please list them.*
Please list any medications the animal is taking, including supplements:*
Describe any injuries, illnesses, procedures, or other conditions that your animal has experienced:*
Information — Location of the appointment:

Your home/ sanctuary
Address*
Setting up for Successful Sessions
- Do choose a quiet time of day/ spot for the session to minimize distractions.

- Do wait 7 days before scheduling an appointment if your horse got injections, dewormed or vaccinated.

- Don't put topicals on your horse before a session. Ex: linaments, heating poultice, Antiphlogistine, homemade blends, essential oils, sprays, etc. Topicals are more prone to be absorbed into the body during the PEMF session.

If your animal is injured:

- Do get clearance from your vet
- Do wait until there is no more active bleeding or ulcers before scheduling a session
Contraindications
Do NOT consent to the use of PEMF on an animal if they have an electrical implant including but not limited to a pacemaker, defibrillator, glucose monitor, or insulin pump, if they are pregnant or you believe they may be pregnant, if they are actively bleeding, have ulcers or are hemorrhaging, if they are the recipient of an organ transplant, if they have injuries or concern of injuries that have not been evaluated by a licensed veterinarian, or if they are exhibiting signs of colic that have not been evaluated by a veterinarian.

Pulse Equine PEMF does not treat or diagnose any injury or illness. Please consult your licensed veterinary practitioner if you believe your animal may have health concerns.
Type your initials below, indicating that you have read and understand the contraindications of PEMF
Consent for Care
I promise to participate fully as a member of my animal’s health care team. I will make sound choices regarding my animal’s health plan based on the information provided by my Veterinarian, PEMF Professional, and other members of my animal’s health care team. I agree to participate in the self-care program that we select. I promise to inform my animal’s health care team any time I feel my animal’s well-being is threatened or compromised.

It is my choice to receive PEMF for my animal, and I give consent for my animal to receive PEMF sessions. I understand that PEMF does not diagnose or treat any illness, disease, or any other physical or mental disorder. I also understand PEMF is a complementary modality and is used to support veterinary care and is not a replacement for any treatment plan. PEMF is not a substitute for medical examination or diagnosis.

I affirm that I have stated all of my animal’s known medical conditions and shall take it upon myself to keep my PEMF Professional updated on my animal’s physical and mental health, agreeing there shall be no liability on the PEMF Professional’s part should I neglect to do so.
Type your initials below, indicating that you have read, understand, and agree to the terms under Consent for Care

I give permission to the therapist to post photos and videos of my animal on Henlea's social media and website.*

YesNo
Unless the therapist receives written notice from the above-named owner/ guardian, this consent to work on said animal will allow for PEMF sessions without continual written consent from the owner/guardian/ leaser.

I agree to pay for all treatments by the end of the sessions or be subject to pay a $5 late fee on each day that passes thereafter.
Print name*
Please note that you will receive a written report via email within a few days of your horse's session (unless specified by the therapist), if you have not received anything check your junk folder or email equinewellness@henlea.com. :)

Cancellations/ Rescheduling:

I require a minimum of 24 hours’ notice for a cancellation or rescheduling. Any cancellation made in the 24 hours before the session will be charged 50%. If the owner/ guardian/ leaser fails to pay, the previously mentioned 5$ per day late fee will be charged.

No Shows:

If I get to the appointment and no one is there and I don’t have permission to work on your animal, you will be required to pay the full amount.

Payment:

My prefered method is e-transfer or by card but I also accept cash.

Please do not hesitate to contact me if you have any questions at all! ☺
I have read and understand your policies.*

YesNo
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Small Animal PEMF — EN

Owner/ Guardian Information:

Animal Information:

Information — Location of the appointment:

Setting up for Successful Sessions

Contraindications

Consent for Care