KB QUARTER HORSES LLC
Horse Intake Questionnaire
OWNER INFORMATION
Owner Name:
First Name
Last Name
Phone Number:
I will contact you directly either text/call to discuss this intake further.
Format: (000) 000-0000.
Email:
example@example.com
HORSE INFORMATION
Registered Name:
Barn Name:
Breed:
Age:
Sex:
Mare
Gelding
Stallion
What is your personal riding skill level?
How long have you owned this horse?
Primary/intended discipline:
What are your main goals for this horse?
Are you looking for training or consignment with us?
TRAINING HISTORY
Has this horse received professional training?
Yes
No
If yes, approximately how much?
Approximately how many rides does this horse have? Or how long has your horse been broke under saddle?
What can the horse currently do confidently?
What areas does the horse struggle with?
Has the horse had an extended period of time off?
Yes
No
What bit/tack is the horse currently accustomed to?
Has the horse been:
Trail ridden?
Yes
No
Shown?
Yes
No
Hauled regularly?
Yes
No
Around cattle?
Yes
No
Ridden outside an arena?
Yes
No
Ridden alone?
Yes
No
Ridden in groups?
Yes
No
BEHAVIOR & SAFETY HISTORY
Has this horse EVER displayed any of the following behaviors?
Buck under saddle?
Yes
No
Buck while saddled/on the ground?
Yes
No
Rear?
Yes
No
Kick or attempt to kick a person?
Yes
No
Bite or attempt to bite?
Yes
No
Strike at a person?
Yes
No
Pull back while tied?
Yes
No
Flip over while tied?
Yes
No
Accept Fly Spray?
Yes
No
Refuse/shut down when asked to move forward?
Yes
No
Become aggressive when saddled or cinched?
Yes
No
Become aggressive when mounted?
Yes
No
Become difficult when bridled?
Yes
No
Become difficult to catch?
Yes
No
Become difficult to load/unload?
Yes
No
Become difficult for the farrier?
Yes
No
Show aggression toward other horses?
Yes
No
Show food aggression?
Yes
No
Become dangerous or unpredictable in a stall?
Yes
No
Jump or go through fences/gates?
Yes
No
Has this horse ever injured a person?
Yes
No
If you answered YES to ANY question above, please explain the behavior, when it last occurred, how frequently it occurs, and any known triggers:
HEALTH & SOUNDNESS
Is this horse currently sound?
Yes
No
Unsure
Has this horse EVER had a lameness issue?
Yes
No
If yes, please explain:
Has this horse had any previous injuries?
Yes
No
If yes, please explain:
Does this horse have a history of or currently have:
Ulcers/suspected ulcers?
Yes
No
Colic?
Yes
No
Back soreness?
Yes
No
Joint issues?
Yes
No
Tendon/ligament injuries?
Yes
No
Hoof problems?
Yes
No
Neurological issues?
Yes
No
Respiratory issues?
Yes
No
Allergies?
Yes
No
If yes to any of the above, please explain:
Does the horse require special shoeing?
Yes
No
If yes, please explain:
Date of last dental work:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of last vaccinations:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
DAILY CARE
Horse is primarily:
Stalled
Pasture kept
Combination
Can this horse safely be turned out with other horses?
Yes
No
Unsure
Does this horse become anxious when separated from other horses?
Yes
No
Any stall habits such as cribbing, weaving, pawing, stall walking, etc.?
Yes
No
TRAINING GOALS & EXPECTATIONS
What are the FIVE most important things you would like us to work on?
What would you consider a successful outcome from this training period?
Are you open to additional training time if your horse requires it?
Yes
No
ANYTHING ELSE WE SHOULD KNOW?
Is there anything about this horse's personality, history, behavior, health, previous handling, or training that would be helpful for us to know?
Submit
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