Massage and/or PEMF

Massage and/or PEMF — EN

Henlea Equine Wellness
Owner/ Guardian/ Leaser Information:
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?*

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Horse Information:
Name*
Age*
Height*
Breed*
Vices*
Have you ever had your saddle fitted to your horse? If so, when was the last time?*
Any unwanted behaviour under saddle such as bucking or spooking?*
When was the last time your horse’s teeth got done?*
What are your greatest challenges with your horse?*
Discipline*
How often is your horse ridden?*
Does your horse have any pre existing conditions?*
Veterinarian*
Farrier*
Has your horse ever had a PEMF session?*
If so, 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.*
Barn Information:
Name of barn*
Barn address*

Setting up for Successful Sessions
- Do choose a quiet time of day/ spot in the barn for the session to minimize distractions. Feeding times and turn out are extremely distracting and can upset horses who do not get to participate.

- 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 (including fly sprays). Topicals are more prone to be absorbed into the body during the PEMF session.

- Do try and keep some distance between you and your horse during the session. Please do watch, but I want your horse to be able to fully focus on me and how his body feels without distractions. I prefer to work in the cross ties (if possible) but will accommodate the horse in what he needs.

If your horse 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 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.

Please contact your veterinarian if your animal has a heart murmur or heart issues. Massage and PEMF increase blood circulation which makes the heart work harder.

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 massage and 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, therapist, 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 and/or massage for my animal, and I give consent for my animal to receive PEMF and/or massage sessions. I understand that PEMF does not diagnose or treat any illness, disease, or any other physical or mental disorder. I also understand that both modalities are complementary and are used to support veterinary care and is not a replacement for any treatment plan.

I affirm that I have stated all of my animal’s known medical conditions and shall take it upon myself to keep my therapist updated on my animal’s physical and mental health, agreeing there shall be no liability on the therapist 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, the undersigned, as the owner/ guardian/ leaser/ of the animal listed above, do herby give consent for soft tissue therapy and/or PEMF therapy. **You are always in control of which therapy you choose for your horse, we will only provide the modalities of your choosing***

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

YesNo
Unless the therapist receives written notice from the above-named owner/ guardian/ leaser, this consent to work on said animal will allow for continuing soft tissue therapy sessions without continual written consent from the owner/guardian/ leaser. I understand that following soft tissue work, the animal could potentially exhibit signs of soreness for up to 48 hours.

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.
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 barn and no one is there to bring me your horse/ horses are not in their stalls and I don’t have permission to work on your horse, you will be required to pay the full amount.

Payment:

My prefered method is debit/ credit card or e-transfer but I also accept cash.

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

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Massage and/or PEMF — EN

Owner/ Guardian/ Leaser Information:

Horse Information:

Barn Information:

Setting up for Successful Sessions

Contraindications

Consent for Care