Healing Reins must have the following for a participant with Down syndrome (Path Int’l Standard: A18)

Each participant with Down syndrome has: 

1. An annual medical clearance from a licensed physician that includes a neurological exam that specifically denies any symptoms consistent with atlantoaxial instability (AAI) 
2. The completed signed and dated physician statement available on-site 

Neurologic signs of AAI always supersede radiographs. The presence of the neurological disorder must be evaluated annually by a physician and is a contraindication for mounted  equine activities. The annual neurological examination must be done for all participants with Down syndrome even if the program system for updating participant information does not  require a complete new set of forms each year. The participant with Down syndrome must have a written statement from the physician that the exam did not reveal AAI or focal neurologic disorder. This may be included on the medical clearance form or could be a separate document.  

This certification of the absence of signs of AAI or decrease of neurologic function by the  physician must be completed prior to starting mounted activities and an annual re-certification  should be completed for continuing participants.  

*Required for Down syndrome from Physician: 
  Present   Absent   Date   

*Please include an annual medical clearance from a licensed physician that includes a neurological exam that specifically denies any symptoms consistent with Atlantoaxial Instability (AAI) is required.