• Elisha Edwards Horse Health

    Consult Intake Form

    For Natural Horse Health Assessment
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Would you like to receive emails from Elisha Edwards Inc regarding program updates, courses, events and other marketing materials?*

  • HORSE PROFILE

    Breed / Sex / Age / Health Concerns
  • *

  • HEALTH HISTORY

    Health Conditions / Stresses / Trauma
  • List any stressful or traumatic events that your horse has experienced and the age at which it occurred. (click the grey button below to add more events)*
  • List the health conditions that this horse has experienced along with their corresponding age. (click the grey button below to add more conditions)*
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  • DIET AND SUPPLEMENTS

    Forage / Vitamins / Minerals / Ingredients
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  • LIFESTYLE

    Forage / Freedom / Exercise / Friends
  • Forage - On average, how many hours is your horse on pasture in a 24 hour period?
  • How many months of the year is your horse on a 100% hay diet?
  • Which forage type do you currently use.
  • How many hours does your horse spend in a stall or confined space in a 24 hour period?
  • Does your horse have the following? Check the box that applies.
    Rows

  • MEDICATION HISTORY

    Medications / Deworming / Dental

  • PHOTOGRAPHS

    Horse and Hoof

  • Please CLICK HERE for requirements and instructions on what photos of your Horse and Hoof are required.

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    DISCLAIMER

    This consultation is intended to provide health information and Elisha Edwards Inc. reminds clients that this information is not intended to be used as a diagnosis or to treat specific health problems or diseases for their animals. The information should not be considered as a substitute for qualified veterinary advise. In the holistic health care model, our aim is to support wellness of the whole body.

    We also provide information on products, but it is the client's responsibility to ensure that any products used are appropriate and that there are no contraindications for their specific situation.

    Elisha Edwards, Elisha Edwards Inc. and their owners, employees, or affiliates will not be held liable or responsible for any loss, damage or health problems caused directly or indirectly by the use or attempted use of any of the information or products. The client should always seek the services of a qualified health care professional.

    I understand that by signing and submitting this form I have agreed to waive and relinquishe any and all claims against Elisha Edwards, Elisha Edwards Inc., their family, extended family, heirs, owners, employees, contractors, affiliates, administrators, executors, or assignees.

  • Date of Signature:*

  • Once you have signed the form with your finger or mouse please be sure to click next, and authorize by accepting the terms on the next page. This will take you to the scheduling page where you can book your appointment with Elisha.

  • Elisha Edwards Inc., 34131 Township Rd 262, Cochrane, AB T4C 14P

    Email: consults@elishaedwards.com, Website: https://elishaedwards.com

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