Client Intake — Ad Astra Eventing

To begin, please fill out our intake form and submit the intake form below and be to sure to include the appropriate release forms which can be found at the bottom of this page.

Name *

First Name

Last Name

Email *

Phone *

(###)

###

####

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Barn Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What services are you interested in? *

Horse Training

Riding Lessons

Human PT Therapy

Human Cryotherapy

Equine Cryotherapy

Human Needling

For PT Services (physical therapy, cryotherapy, needling):

Please share your current symptoms, any injuries, goals for treatment, and what else you've tried in the past:

For Training or Lesson Services:

Please share details about yourself and your horse, you and your horse's experience, goals for training or lessons, and anything else you feel would be helpful to include:

How did you hear about us?

Referral

Horse Show

Online

Other

Any additional information or questions:

Thank you!