Animal Awareness - Equine Phone Consultation With Jean-Pierre

Have You Always Wanted to Know How to Improve Your Animal's Wellness?


Wellness For You & Your Animal	Your Dog & Horse Hands-On Home Care Program Starts Here

Equine Phone Consultation with Jean-Pierre - Sending Check or Money Order

Owner's First and Last Name:
Email:	Phone:
Animal Name:	Breed:
Age:	Size:	Weight:
Type of activity:
Any particularities:
Briefly describe the present condition:
What Happened:
When:
Where on the animal:
How did it happen:
When applicable, give a brief history of past injuries:
What are your goals:
Animal's Diet:
Any Nutritional supplements:
*Any other important information you want Jean-Pierre to know:* To your best knowledge, check the right information
Level of Conditioning: Poor Beginner Intermediate Advance	Arthritis in: Upper Neck Lower Neck Left Front Right Front Left Hind Right Hind Withers Back Sacrum Tail Hips		Temporomandibular (TMJ) dysfunction syndrome: None Yes - Left Yes - Right Yes - Both
Does your horse bend his neck equally to both sides: Yes No			If no, which side is most restricted: Left Right
Does your horse move his body when you bend his neck: (ie. Step back or sideways to shift weight.) Yes No
Does he rotate his head in order to bend his neck to the same side: Yes No

Are his forelegs moving equally: Yes No	If not, which one is most restricted: Left Right
Are his hind legs moving equally: Yes No	If not, which one is most restricted: Left Right
When making circles, is your horse comfortable going to: Left Right Both
When bending to the restricted side, does your horse break the bend from the:	Upper Neck Lower Neck Mid-Back Hinds
Does your horse hold his breath: Yes No	Is the wear and tear of your horse’s shoes even?: Yes No
Does your horse sweat evenly on both sides and in each area of his body? (this should to be checked at different time intervals while riding) Yes No
Looking at his feet, are all heel equals: Yes No
Which of the 4 hooves have low heels: LF RF LH RH
Which of the 4 hooves have high heels: LF RF LH RH
Does your horse pull the reins out of your hands? Yes No	Does he seek contact too abrupt ? Yes No
Is your horse elastic in feel or just stuck in a frame? Elastic Stuck
While riding does your horse feel like it stabs the ground and is not light on his feet? Yes No
Which side while riding, using the reins, is the stiffer side? Left Right
Does your saddle sit to one side always? Yes No	Even in halt? Yes No
Does your saddle shift to the outside in both directions or in one direction? Left Right Both No Shift
Does your saddle sit to the inside in both directions or is level? Left Right Both Level
Coming out of a corner is the saddle shifting to the outside? Yes No
Can your horse change his neck position from left to right and back without coming up (tension) or dropping the bit? Check at: Halt Yes No Walk Yes No Trot Yes No Canter Yes No
Upload Video Clip Maximize your consultation by supplementing the Animal Profile Form with a short video (3 minutes max) of your horse in motion. Your horse may be ridden under saddle or worked in hand. Please include the following: Animal walking away from the camera for 30 yards, turning, and walking back towards the camera. Animal trotting away from the camera for 30 yards, turning, and trotting back towards the camera Animal walking from right to left, then left to right, filmed from the side - 30 yards each side Animal trotting from right to left, then left to right, filmed from the side - 30 yards each side Remember: Videos must be no longer than three (3) minutes. I will study the profile form along with the video before we speak to help provide you with the most complete assessment possible.

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