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Earth Horse Healing

Ginger Krantz - Healer, Teacher, Mentor

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Large Animal Intake Form

Large Animal Intake Form

Please fill out and submit this form at least 48 hours prior to your initial appointment. Required fields are marked with a red asterisk. The information you provide is held as private and will not be shared without your expressed permission.

"*" indicates required fields

Name of Owner*
Address*

Description

Sex*
The Age Specified Is:*

Aquisition

Lifestyle and Management

Caged or stalled? How many hours a day inside or outdoors? On grass or dirt outdoors?
Do you utilize fecal testing?*
How frequently do you worm?
Please list vaccinations and include frequency of shots. Also, please explain if and how the routine and frequency has changed over the years.

Medical History

Include anything historic and significant that has occurred while you have cared for this animal and prior to your acquisition, if known.
Surgery, illness, malnutrition, etc.
Abscess, tendon strain, arthritis, fall, injury, etc.

Current Condition

Any health issues this animal has presently.
For reference only. I will not contact your veterinarian unless you specifically ask me to.
Please list any medications your animal is currently taking: dosage; start and end dates of meds; and why.
Is your animal comfortable being touched all over its body?*
Where on its body is it not comfortable being touched and what is his or her reaction?

Your Relationship With Your Animal

This section is optional, you can skip to the next if you choose.

Healing Session Focus

Please take the neccessary time to consider the following questions.
Examples: Deepening the bond between us, more mutual understanding or clearer communication.

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