Forms
Forms for Therapy Program Patients
Please review each of the forms below. All of these forms need to be completed, signed, and submitted prior to evaluation. If you have any questions on the form please do not hesitate to contact us.
* You will need to have Adobe Reader to view and print the forms. If you do not have it, you can download it here.
- To be filled out and signed by Patient:
- Patient's Consent for Release of Information
- Emergency Medical Information and Liability Release Form
- Fee Agreement
- To be filled out by Physician's Office and signed by Patient:
- Patient's Medical History and Physician's Statement
- Prescription
- Hippotherapy Contraindications
Forms For Nature Classes
All participants in the Nature Classes are required to fill out emergency medical information and sign a liability release form only. Please bring this form with you to the class.