Bullseye Equine New Client Paperwork

Bullseye Equine is committed to providing an outstanding and professional experience to all of my clients. I have adopted the following policies:

 

ARRIVAL TO YOUR SESSION
Please have your horse ready for the practitioner at the scheduled appointment time. Horses that are excessively dirty, sweaty, or wet cannot be worked on. 

 

Please do not apply any coat sprays (ShowSheen, Shine Spray, etc.) directly before a session, this decreases the efficacy of some modalities. Fly spray is welcome and encouraged. 

 

Please have your horse ready in the stall or cross ties, practitioner cannot catch or turnout horses in the field for insurance reasons. If your horse was recently ridden or turned out before a session, please allow them time to rest and relax, to urinate or get a drink, so they are comfortable and relaxed for their session.

 

If this is your horse's first session, please have someone available to jog, lunge, and/or ride the horse so their movement can be assessed. For follow up sessions, please have someone available to briefly jog the horse, unless otherwise noted by practitioner.

 

LATE ARRIVAL POLICY
If your horse is not ready at the scheduled start time, I will wait 15 minutes, after which time the session will be automatically cancelled and charged according to our cancellation policy.

At the discretion of Bullseye Equine, we may be able to accommodate a partial session for late arrivals, but to be fair and courteous to everyone’s time, your service(s) may be shortened in order to keep on schedule.

 

 

PAYMENT
Invoices will be sent to the email on file shortly after services are rendered, and payment is due at time of reciept. Invoices can be paid by cash, check, credit/debit card, or bank transfer. Payment that is 30+ days late will automically incur a 5% late fee. 

 

CONFIDENTIALITY
The discussion between Bullseye Equine and the client is private and confidential.  Your horses' records are strictly confidential and will not be discussed or released to anyone but the horse’s owner/agent without the owner’s permission – this includes transferring or releasing records to the horse’s veterinarian, new or previous owners, leasers, or other care team members.

 

EXISTING AND NEW MEDICAL CONDITIONS
It is the responsibility of the client to keep Bullseye Equine informed of any medical treatment, current medications, or changes in the animal’s health condition before each session. Failure to do so may put your horse at risk. 

 

Pertinent changes include, but are not limited to:

• tendon or ligament injuries
• muscle injuries or disorders
• changes to medications
• recent IM/IV or joint injections
• vaccines
• shockwave
• pregnancy
• blood clots or bleeding disorders
• gastric ulcers
• cancer/tumors
• infection
• heart conditions
  
  Horses that are acutely dehydrated, or with elevated vital signs (fever, high heart rate or respiratory rate) will not be worked on. If necessary, the client may be asked to obtain written permission from the veterinarian that our services are safe to continue, especially if the horse is currently being rehabbed for any injuries or conditions.

 

I understand it is my responsibility to inform Bullseye Equine of any changes that would make services contraindicated for my horse, as detailed above.

 

Horses that are currently rehabbing from any injury or ailment are required to obtain a veterinary approval form as provided by Bullseye Equine before services can begin. Any horse that is discovered to be lame or ill without being disclosed prior to the appointment by the owner will not recieve services, but will still incur my evaluation fee ($100). 

Kailyn Pupa, MSc, NAVP

MSc Veterinary Physiotherapist; National Association of Veterinary Physiotherapists; FEI Permitted Equine Therapist; Certified Equine Bodyworker; Certified Equine Myofascial Release Practitioner; Certified Equine Kinesiology Taping Practitioner; Independent Bit and Bridle Fitter

 

*It is understood that that this Client Consent Form is applicable to all horses listed above and that each separate horse must also be accompanied by an Equine Intake Form, as provided by Bullseye.

Services Consent and Veterinary Disclaimer
I, the undersigned, am at least 18 years old, and I am the owner/duly authorized agent for the owner of the animal(s) described herein and I have the authority to execute this consent for equine bodywork care and services.

I hereby grant permission for bodywork services to be performed on this animal(s) forever releasing Bullseye Equine (“Bullseye”) and its agents from any and all liability for performing said services.

I certify that the animal(s) referenced herein has a primary veterinarian it receives routine veterinary care with. I understand that Bullseye solely provides equine bodywork and that Bullseye and its agents are not licensed veterinarians. I understand that bodywork services do not replace proper veterinary care. As equine bodyworkers, Bullseye will never diagnose your animal, prescribe any medications, nor treat any illness or disease. Kailyn Pupa is a qualified veterinary physiotherapist in the UK. 

Initial and date below to grant Bullseye permission to contact the animal’s primary veterinarian, farrier, and/or trainer as deemed necessary to aid in creation of equine bodywork plan(s) for the animal(s) referenced herein. All information will be kept confidential unless required by law or with the owner/agent permission.

Equine Bodywork Services Acknowledgment
Due to the multiple variables inherent in bodywork services, it is difficult to predict the duration and frequency required for the recommended services course and results of equine bodywork cannot be guaranteed. It is the responsibility of the undersigned to make known any latent pathological defects, illness, and/or deformities that would otherwise impact or interfere with the equine bodywork services offered. Animals with undiagnosed lameness that have not been evaluated by a veterinarian and animals which are not currently in the care of a primary veterinarian are not eligible for Bullseye services.

The undersigned certifies that the animal(s) referenced herein has had regular veterinary care and warrants that the animal’s primary veterinarian has cleared the equine for bodywork services.

I understand that it is my responsibility to keep Bullseye informed of any medical treatment, current medications, or changes in the animal’s health condition before each session of bodywork services. I understand that failure to do so may put my animal(s) at risk.

Risk Assumption and Liability Release
The nature of the equine bodywork services provided by Bullseye have been explained to me and I have also been informed that there are certain risks and complications associated with any services of this type. These risks have been explained to me as well. I understand and agree that Bullseye and its agents reserve the right to stop an appointment at any time if it is felt that their or the animal’s safety is in question and/or if the animal is not responding appropriately to the services.

While I accept that all services will be performed to the best of the abilities of Bullseye, and that all reasonable precautions will be taken against injury or escape of the animal, I understand that no guarantee has been made regarding the results that may be achieved. Further, I understand and agree that Bullseye will not be liable or responsible to any person under any circumstances for or on account of the care or safe keeping of the animal, and I accept and assume all risk with respect to the bodywork services provided and husbandry of the animal while such services are rendered.

I fully understand that Bullseye does not carry any insurance on the animal(s) referenced herein in regard to transportation of same for bodywork services. Premise and location risks wherein the animal is receiving Bullseye services are to be borne by the owner/authorized agent.

Indemnification and Hold Harmless
I agree to defend, indemnify, and hold harmless Bullseye with respect to all claims, demands, and/or causes of action, including attorney’s fees and costs, arising out of or in connection with any action brought by third parties relating to equine bodywork services and associated activities provided to the animal(s) referenced herein by Bullseye.

Client Certification
I agree to assume financial responsibility and provide payment at the time that services are rendered. I have received and reviewed the qualifications/certifications for Bullseye/Kailyn Pupa and understand none are for a Doctor of Veterinary Medicine degree. My questions have been answered, and I have read and fully understand this form in its entirety and authorize bodywork services for the animal described herein. This consent is binding valid until revoked in writing.

The parties agree that electronic signatures, if appearing on this consent form, are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.