Please complete this form before your horses' first visit. You maybe required to resubmit this form for subsequent treatments if the conditions have changed or for those not undertaking reqular treatments
Are you completing this form for an... *
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Initial Registration
Update of details
Annual renew of declaration
Owner Name
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First Name
Last Name
Owner Email
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example@example.com
Owner Address
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Street Address
Street Address Line 2
City
State / Province
Post Code
Phone Number
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Please enter a valid phone number.
Horse's Name
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Horse's Age
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Horse's Approx Weight
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Horse's Height
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Horse's Breed
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Horse's Sex
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Mare
Gelding
Stallion
Horse's Usual Vet and Practice
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Phone Number
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Please enter a valid phone number.
Horse's Referral Vet and Practice if applicable
Phone Number
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Please enter a valid phone number.
Please state you reason for using the Water Treadmill:
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Vet or Physio referral? Weight Management / Fitness / Schooling Goals / General Condition etc
Does your horse have a current or ongoing medical issue that is under Vet supervision
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Yes
No
If yes please provide details
Referral Source: Was your horse referred to us by a veterinarian, physiotherapist, or other healthcare professional? If yes, please provide details of the referring individual or clinic.
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Yes
No
If yes, please provide details, and if any specific programmes were provided for the horse?
A Vet Consent Form must be completed by the attending veterinary surgeon prior to any horse undergoing hydrotherapy or related therapeutic services at Yorkshire Equestrian Centre / The Hydrotherapy Hut where the horse has current or ongoing medical issues that are under the care of a Vet. For horses attending for general fitness, conditioning, or maintenance use without any current or ongoing medical issues, formal veterinary consent is not required. However, we strongly recommend that you inform your vet, physiotherapist, and farrier that your horse is beginning Water Treadmill sessions, especially where there may be underlying asymmetries or management considerations. You can find our online vet consent form on our website or ask your vet to email us with consent and details.
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I understand I will get my Vet to provide YEC direct with their consent before the first session
Consent not needed, but I understand it is sensible to inform my vet and or physio
Has your horse used a Water Treadmill before?
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Yes
No
If yes, please provide details, how often, any specific programmes provided for the horse?
Does your horse have any relevant medical issues, needs or previous injuries?
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Yes
No
If yes, please provide details
Horses cannot use the treadmill if they have road pins, spikes or studs in their shoes. Rounded head road grips are permitted. Horses should also not use the treadmill within 5 days after being shod, as the fresh nail heads will be too grippy on the belt.
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Shod
Unshod
Please confirm that your horse has completed the primary course for Equine Flu and is within date for annual boosters. Proof of vaccination will be required on arrival, failure to prove will result in no treatment.
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Full course completed, on annual boosters
2nd vaccine of primary course completed, not due 3rd vaccine yet.
Does your horse have regular routine check ups with a dentist, bodywork specialist and saddle fitter?
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yes
no
Is your horse known to display behaviour such as rearing, kicking out or fear of water?
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yes
no
If yes please provide details
Horses current workload
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Just broke and riding away
Dressage / Schooling to Elementary level
Dressage / Schooling Medium level and above
Hacking
Jumping under 1.10m
Jumping over 1.10m
Competing SJ/XC
Retired - sound
Broodmare
Out of work - no injury
Out of work - injury / rehab
What goals would you like your horse to achieve by using the water treadmill?
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Weight Loss, enhancing rehab, improving stride length, topline and core etc
Is there anything else that you feel is relevant to tell us
1. General Declaration and Prior Permission
I agree to comply with all rules and regulations set below by the YEC during my visit.
2. Health Precautions:
I confirm that my horse is free from infection and disease prior to using any facilities or treatments at the YEC. I agree to disclose any health issues or injuries to the YEC staff before treatment.
3. Insurance Coverage:
I acknowledge that I am responsible for ensuring that my horse is adequately insured for third-party liability and veterinary fees. I agree to provide a copy of my insurance upon request by the YEC.
4. Safety Protocols:
I agree to dress appropriately and wear personal protective equipment, including sturdy non-slip footwear, while on the premises of the YEC. I understand that failure to comply with safety protocols may result in termination of my booking. I confirm that my horse is well handled, and has no vices such as kicking. I understand if my horse cannot be safely handled due to behaviour, the session may be terminated and not reimbursed.
5. Cancellation Policy:
I understand and agree to the cancellation policy of the YEC. Any changes or cancellations must be made in accordance with the policy to avoid charges.
6. Privacy Policy:
I acknowledge that my personal information provided to the YEC will be used for booking purposes, statistical analysis, and customer service queries. I understand that my information will be stored securely and will not be shared with third parties. I understand that YEC may use any photos or videos taken for their training, social media and website. I understand that I need to inform YEC beforehand if I wish for my horse or myself to remain anonymous on names. I understand that CCTV is in operation at YEC.
7. Disclaimer & Waiver:
I understand that treatments and therapies at the YEC carry inherent risks, and I voluntarily assume these risks for myself and my horse.
8. Termination of Services:
I acknowledge that the YEC reserves the right to terminate any service or treatment session in the event of breach of terms or outstanding payments.
By signing below, I confirm that I have provided YEC / The Hydrotherapy Hut with all relevant information about my horse. I will inform them of any relevant changes to my horses details. I have read, understood, and agree to abide by their terms and conditions stated on their website and above.
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Date
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Day
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Month
Year
Date
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