Equine Owner Consent

Please fill out the following form.

Full Name

Home Address

Phone

Email

Animal Name

Animal Address (If different from home)

Sex

Animal Age & DOB (If known)

Breed

Height

Registered Veterinary Practice

Has your horse ever shown any signs of anxiety or agression.

Is there anywhere your horse does not like to be touched.

I am happy to allow photos of my animal to be taken and used for social media and advertising purposes.

Yes

No

By completing this form, you consent to physiotherapy treatment for the horse named above by McMasters Veterinary Physiotherapy.

Signature

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Equine Owner Consent Form