Organisers Contact Number
Address Line 1
Address Line 2
State / Province / Region
Number of horses for treatment
Equine Sports Massage
This will allow us to identify the equipment we need to prepare for the visit
Have you used E-quineRehab.com before?
I agree to the TheraPlate Consent Form
* The TheraPlate is not suitable for the treatment of blood clots.
* I understand there may be temporary muscle soreness post therapy.
* I am aware that a TheraPlate therapist does not diagnose illness, perscribe medications,
manipulate the body or give medical advice.
* I am aware that the TheraPlate may help improve certain conditions, however results are
* I will tell the TheraPlate therapist of any discomfort during the protocol.
I have read and agreed to the below cancellation policy
When you book your appointment, you are holding a space on our calendar that is no longer available to our other clients.
In order to be respectful of your fellow patients, please email firstname.lastname@example.org as soon as you know you will not be able to make your appointment.
If cancellation is necessary, we require that you confirm at least 48 hours in advance.
Appointments can be in high demand, and your advanced notice will allow another client access to that appointment time.
How to Cancel Your Appointment
If you need to cancel your appointment, please email us at email@example.com between the hours of 09:00 – 21:00.
A cancellation is considered late when the appointment is cancelled less than 48 before the appointed time.
A no-show is when a client misses an appointment without cancelling. In this instance we will debit the cost of the required service from the card used to book the appointment.
I accept that a booking fee is required and that will be refunded to me on the day of visit if over 10 horses are booked.
A deposit is required due to cancellation policy
Credit / debit card number
Name on Card