Gotcha Equine Symptoms Survey
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Horse's Name? *
Horse's age? *
Horse's height? *
Horse's weight? *
Horse's gender *
What breed is your horse?
Location of your horse/s *
Town or Suburb, and State
Horse's Occupation? *
eg Pleasure Riding
How long have you owned or leased this horse?
How many other horses graze the same pasture as this horse?
Are any of the other horses on the same pasture showing health or behaviour problems, please list other horses problems.
Have you ever had a horse die or euthanised? If so why?
Does your horse exhibit (past and present) any of the following behaviours?
Has your horse ever displayed any of the following physical signs at any time?
Has your horse ever exhibited any of the following abnormalities, ailments or illnesses?
Has your horse ever displayed the following
If this survey is regarding a mare of filly, does she display any of the following?
Do you suspect other health issues not yet identified?
Have you noticed if any symptoms are seasonal and if so when?
List the symptoms that occur during the season you have indicated above, and how you manage them.
How often and for how long  is your horse worked per week?
How is your horse kept?
What hoof care regime to you use?
Has your horse ever suffered an injury due to the bad behaviours identified in this survey?
Have you ever suffered any kind of injury due to the above behaviours?
Which of the following have you also used as part of your investigation in to issues
What have you found that has helped your horse's problems so far?
What type of pasture is your horse grazing?
What weeds are in your horses pasture?
What trees over hang your pasture fence or grow in the paddock?
What source of water does your horse/s have access to full time?
Do you own the property where your horse resides or do you lease or agist?
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When was the pasture last fertilised?
When was the pasture last re-seeded?
If your pasture has been fertilised  and/or re-seeded please list with what and fertiliser brand name, plus how frequent.
What is your farming method?
What grazing method do you use?
What tests have been conducted
What is your manure management method?
When was your horse last de-wormed?
MM
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DD
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YYYY
Besides grass what other feed and hay make up your horses diet?
Do you currently supplement your horse and if so with what?
From the survey results would you like to receive product and dose rate recommendations for you horse via email?
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Would you like to receive news updates via email?
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Your Full Name: *
Your contact phone number: *
Best day and time to chat about your horse this coming week?
Your email address: *
General comments or concerns you have with your horse or horses:
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