24 hr emergency service
CLIENT ONLINE BOOKING FORM FOR AN EQUINE CHIROPRACTIC CONSULTATION
Please use this form to arrange a chirorpactic appointment for your horse.
Chiropractic appointments are with Dr Kate Haines only
Your name:
Please enter the same name as used at the clinic
Preferred contact method:
Phone
Email
SMS
Phone number:
Email address:
The best time to contact you by phone:
Address:
Horse name:
Has Dr. Haines seen this horse before :
Yes
No
If no, please fill in details below:
Breed of Horse:
Age of horse:
What is the horse used for:
Nature of problem:
If lameness - we recommend assessment by your own vet first if possible.
If prepurchase exam, the situation must be discussed with Dr Haines.
If Dr Haines has not contacted you within 3 days of submitting this form,
we recommend ringing the clinics direct to talk to her
Appointment preferred location :
Morwell Pony Club:
(no travel charges, earlier appointment)
At home or other property
(will incur travel charges, may wait until organised trip in that area)
Preferred time:
Morning
Afternoon
