HRB Intake Form 2026 – English

Do you have more than one horse for a session? Please complete a separate intake form for each horse.

General information about the owner.
Company name
first name
last name
email
mobile
General information about the horse/pony.
Please enter the horse’s general information below.

(Do you have more than one horse for a session? Please complete a separate intake form for each horse.)
name horse
Address and city where your horse is stabled. Address and city where your horse is stabled.
Adres en huisnummer Woonplaats Provincie Postcode Land
What is the breed, age, and sex?
Intended use
Please enter the horse’s additional information below.
Are there any areas that the horse does not want me to touch?

Are there any areas that the horse does not want me to touch? No If so, which areas? If so, which areas?
Housing
What is the horse’s temperament like?
Diet
How does the horse eat?
Date of the last dental check-up.
(Important information for the session.)
Is the horse dewormed regularly?

Is the horse dewormed regularly? yes no
When was the horse last dewormed?
Is the horse vaccinated regularly?

Is the horse vaccinated regularly? yes no
When was the horse last vaccinated?
the problem
What challenges are you experiencing with your horse?
How does this manifest itself?
Is your horse currently under veterinary care?
(for example, due to stall rest or a similar situation)

Is your horse currently under veterinary care? (for example, due to stall rest or a similar situation) No If so, why? If so, why?
I will contact you as soon as possible.
How did you find me?

How did you find me? facebook instagram google friend/acquaintance by chance word of mouth other, please specify: other, please specify:
I also use measurements to determine which herbs may help support your horse’s general well-being.
This is not a medical treatment, but a natural addition to your horse’s daily care.
I can provide you with more information about this when I visit you.
Upload a photo of your horse without any other horses, animals, riders, or people in the picture. To prevent any confusion, please upload a photo showing only the horse described above. The file must be one of the following file types: jpg, jpeg, png, gif, bmp, heic, or pdf.
Privacy Policy and General Terms and Conditions

Privacy Policy and General Terms and Conditions
By submitting my information, I agree to your Privacy Policy. I also confirm that I have carefully read and understood your General Terms and Conditions.

HRB Intake Form 2026 – English

HRB Intake Form 2026 – English

Please enter the horse’s general information below. (Do you have more than one horse for a session? Please complete a separate intake form for each horse.)

I also use measurements to determine which herbs may help support your horse’s general well-being. This is not a medical treatment, but a natural addition to your horse’s daily care. I can provide you with more information about this when I visit you.

Please enter the horse’s general information below.

(Do you have more than one horse for a session? Please complete a separate intake form for each horse.)

I also use measurements to determine which herbs may help support your horse’s general well-being.
This is not a medical treatment, but a natural addition to your horse’s daily care.
I can provide you with more information about this when I visit you.