Programing

Participant Age(Required)

Participant Email *(Required)

Participant Phone(Required)

Has the participant ever participated in equine-assisted services before?(Required)

If yes, where and when?

We would like to be sure we are accurately matching you with services that meet your needs. Please select all that apply.

Please Select Facility Location(Required)

Therapy Services in an Equine Environment - often called hippotherapy

Mental Health Services - often called equine assisted psychotherapy

Equine Assisted Learning - education or team building focused

Adaptive Horsemanship - often called therapeutic riding

Recreational/Traditional Horseback Riding

Please check all days and times that work for your schedule.

Please share any additional contact information that might be different than the participant's information.

Email

Phone

New Participant Intake Questionnaire