Equine Client
Intake Form

I understand that the craniosacral therapy received here is for the purpose of stress reduction,
emotional and physical release, re-balancing and increasing energy flow in the body. I understand
that Joyce does not diagnose illness, disease, or any other physical or mental disorder. The services
provided as set forth herein, are not to be construed as a substitute for professional veterinary care,
proper nutrition, exercise or training. I have made her aware of existing conditions and will report any
changes as they occur.

I agree to have my horse receive a biodynamic craniosacral therapy session and I understand
that it may take more than one session to affect change. I also understand that the horse may
temporarily experience an energy release that may be uncomfortable, and I WILL NOT hold Joyce
Harader responsible. I understand that Joyce is available to me, if questions or further discussion of the session is wanted.
I understand that if I need to cancel an appointment, I need to do so with a minimum of 48 hrs.
notice. A cancellation with less than 48 hrs. notice will be charged a full appointment fee.

I have read and understand the above disclosure statement pertaining to the therapy to be performed on my animal companion(s). I (owner or agent of owner) agree and give my consent for this therapy to be given to my animal(s) until I decide otherwise. I understand that this therapist is not a veterinarian. This is in accordance with the Illinois Veterinary Medicine and Surgery Practice Act of
2004.