Appointment request form

Appointment request form

Please give as much information & detail as possible. This helps me ensure that your appointment is productive and educational!
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Barn Name (If kept at home, state "Home")*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Gate Code (if applicable)
Rider Details
Gender*
Age*
Weight*
Height*
Any physical issues that I need to know about?
Bad hip(s), stiff back, pain while riding, etc
Horse Details
Has your horse, or any other horse in your barn, or you, traveled to, been exposed to or diagnosed with a communicable disease in the past 30 days? This includes Ringworm, Lice/Mites, Strangles, Equine Herpes and others.*

YesNo
Name*
Breed*
Age*
Gender*
Height*
Color*
Riding Discipline (e: Dressage, Roping, Jumper, All around, Trail, etc)*
Experience / Work Level
Any issues or concerns regarding saddle fit or behavior related to saddle?*
Visit information

Please be as detailed as possible!
Reason for appointment*
Appointment Preferences
Day(s) of the week that you can do an appointment*

Tuesday AMWednesday AMThursday AMFriday AMSaturday AMTuesday PMWednesday PMThursday PMFriday PMSaturday PM
If you are looking for a New or New-To-You saddle, complete this section
Type of saddle

DressageGeneral Purpose (English)Jump/Cross CountryWestern TrailCuttingRopingRanchCowhorseOther
Condition

New / DemoUsed
Material(s)

LeatherSyntheticHybrid Leather and SyntheticNo preference
Saddle Color
Seat Size
Tree width or type
Price Range / Budget
Tack Shop request

Anything in stock on our website or store can be brought to the appointment for you to look at and purchase. Bringing products to the appointment does NOT require you to purchase, but is a service to make shopping easier for you! All products can be found here: https://shopridersemporium.com
Saddle Pad - include brand, color & type
Girth - include brand, color & size
Leather care - include brand & product name
Horse grooming items
Benefab products
Thinline products
Blankets & Sheets
Last section! The Fine Print

This form is for use ONLY by Riders Emporium, LLC and may not be shared, copied or reproduced without the written and signed permission of Riders Emporium LLC and should credit Riders Emporium, LLC with the development. Unauthorized reproduction of this form, in any capacity, is strictly prohibited. Version 1.2 2025/Sept **Riders Emporium always recommends and encourages riders to engage their entire care team (Farrier, Massage, Chiropractic, Veterinarian, Dentist, Trainer/Coach, Nutritionist, Saddle Fitter, etc) to create & maintain optimal health, soundness, and muscle for your horse(s).**
By submitting the above, you acknowledge that 1.) you have provided Rider’s Emporium with truthful and up to date information for the appointment, 2.) you have permission from the barn owner to have Riders Emporium on property for the appointment, 3.) understand that the tracings, notes, recommendations, etc. made at this appointment are based on the horse’s condition at the time of the appointment & may change if the horse’s condition, workload, or overall health is impacted between appointments, 4.) understand that Rider’s Emporium’s Privacy Policy, Terms & Conditions, and Return/Refund Policy are listed on the website, www.ridersemporium.com, and are available for your review at any time, 5.) Payment for services is due at the time of appointment or when invoiced, and, 6.) Credit card payments will be charged an additional 3% due to processing fees.*

Yes
Social Media Release: Rider's Emporium may utilize photographs and/or video to document the saddle fitting process. These photographs/videos may also be utilized on our Website and Social Media pages to help others learn about the saddle fitting process and to show work completed by Rider's Emporium. We will NOT tag you or otherwise identify you by name.*

Yes, I grant permission for Rider's Emporium to utilize my image and my horse's image (photographs and/or video) for use in media publications such as websites or social media and educational materials. I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used by Rider's Emporium now, or in the future, whether that use is known to me or unknown. I waive any right to royalties or other compensation arising from or related to use of the Image(s) or Video(s).No, I do not grant permission for Rider's Emporium to utilize my image or my horse's image (photographs and/or video) for use in media publications such as websites or social media or educational materials.
Should be Empty:

Appointment request form

Rider Details

Horse Details

Visit information

Appointment Preferences

If you are looking for a New or New-To-You saddle, complete this section

Tack Shop request

Last section! The Fine Print