Demographic Survey
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Thank you for taking the time to complete this questionnaire. The purpose of this demographic form is to gather background information about participants’ professional experiences and qualifications related to equine-assisted interventions. Your responses are confidential, voluntary, and will be used only to contextualize interview data for this study. You may skip any question you do not wish to answer.
Informed Consent
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Age Range
Under 25
25–34
35–44
45–54
55–64
65 or older
Gender Identity
Female
Male
Non-binary / Third gender
Prefer not to say
Prefer to self-describe: ______________________
Geographic Location
Years of Experience in Equine-Assisted Interventions
Less than 1 year
1–3 years
4–6 years
7–10 years
More than 10 years
Professional Certifications or Credentials
PATH Intl. (e.g., ESMHL, CTRI)
EAGALA
Equimotional
Mental Health Professional License (e.g., LPC, LCSW, LMFT)
Occupational Therapy / Physical Therapy Credential
Social Work Credential
Other certification(s): ______________________
None
Type of Populations Served
Neurodivergent individuals (e.g., autism, ADHD): ______ % of practice
Individuals with mental health needs
Individuals with physical disabilities
Older adults
Other (please specify): ______________________
Neurodivergent individuals (e.g., autism, ADHD): ______ % of practice
Age Groups Served
Children (under 12)
Adolescents (13–17)
Young adults (18–24)
Adults (25–64)
Older adults (65+)
Educational Background
High School / GED
Associate’s Degree
Bachelor’s Degree
Master’s Degree
Doctoral Degree
Other: ______________________
Professional Practice Setting
I own or operate my own equine-assisted practice
I work for an established equine-assisted practice
I work within a healthcare, educational, or community organization
Other (please specify): ______________________
Name
First Name
Last Name
Email
example@example.com
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