Equine Trial Questionnaire
Thank you for considering a donation of your equine to Healing with Horses Ranch. Please review our requirements as stated below, and let us know if you have any more questions.

Healing with Horses Ranch accepts donations of equines into our program after passing an evaluation and trial period at the Healing with Horses Ranch facilities.  Equines who come to Healing with Horses Ranch will partner in our Equine Facilitated Learning (EFL) / Therapeutic Riding Program.

Healing with Horses Ranch require thats:
The Horse Donation questionnaire be filled out in full and with as much detail as possible for our records
This way we will be able to be as consistent as possible with your friend!
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Email *
Date
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What are you interested in? *
Do you have 100% ownership of this equine? *
Name of owner(s) *
Address of Owner
Phone number of Owner *
Address where the equine is stabled
Phone number of stable
Name of the equine that is being evaluated for donation into the Healing with Horses Ranch Adaptive Riding, Veterans, and or Counseling Programs.  Please include its name and its registration name if applicable. *
Sex *
Height *
Breed
Color
Markings
Other markings or numbers
Age (birthdate) *
If you don't know the exact month and day please put January 1 of the year they were born
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Approximate weight
feed type, amount, and meds currently receiving *
The equine is sound *
Temperament *
Very quiet
Highly spirited
Friendliness towards adults *
extremely friendly
Does not like adults
Friendliness towards children *
extremely friendly
Does not like children
Friendliness towards other horses *
extremely friendly
Does not like other horses
Friendliness towards other dogs *
extremely friendly
Does not like other dogs
How often is equine currently being ridden? *
How often is equine currently being ridden? Please explain your answer.
This equine can be ridden by *
Required
This equine has been trained or has experience in
Has this equine ever *
Required
Please explain the circimstances of the above behaviors. *
This equine is easy to *
Required
Any previous lameness? Please explain. *
Any previous health issues? Please explain. *
Any special needs? Please explain. *
When was your horse last vaccinated against Rabies?
*
Required for equines on our property - if your horse has not received this vaccination please select the date that they will be vaccinated
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When was your horse last vaccinated against Flu Rhino? *
Required for equines on our property - if your horse has not received this vaccination please select the date that they will be vaccinated
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When was your horse last vaccinated against West Nile?
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When was your horse last vaccinated against E/W/V Encepholomyelitis?
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When was your horse last vaccinated against Tetnus?
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When was your horse last vaccinated against Strangles?
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What is the date of the equines most current coggins test *
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When was the last time that the equines teeth were floated? *
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When was your equine last de-wormed or checked for worms and what type of dewormer was given (if any)? *
When was the last time he was seen by the farrier *
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When was the last time he was seen by the farrier *
Name and contact info of current vet *
Why are you considering donating this equine to Healing with Horses Ranch? *
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