Appointment Request Form
Are you a new client?
*
Yes
No
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Preferred Method of Contact
Email
Text
Call
Horse(s) Name
*
Address or Farm Name Where the Horse is Located
What date and time work best for you? *Please advise I do have a day job so Gray Horse PEMF operates M-F from 4pm-7pm and Saturdays 9am-7pm.
Has your horse(s) had PEMF done before?
Yes
No
Unsure
Tell us a little bit about your horse(s): Discipline, how many days ridden, any issues, etc.
What would you like to book?
Full Body Session $65
Targeted Area Session $35
Kinesio Taping $15
Ice + Compression Boots $10
Red Light Therapy $25
Submit
Should be Empty: