By completing the consultation form below and clicking "Send" - a copy of this consultation form will be sent to Leigh at Essentials for Equilibrium, a copy will also be sent to your email address for your records.
Name of Animal:
Tel:
Address of Owner/Carer:
Veterinary Surgeon/Practice:
Species:
Gender:
Age:
Size:
Breed:
How Long Has This Animal Been in Your Care?
What Other Animals Live With This One?
Brief Description of Illness/Behaviour To Be Addressed:
Date of First Symptons:
Any Veterinary Treatment or Diagnosis:
Is Your Animal Receiving Any Prescribed Medication? Please Give Full Details:
Possible Cause of Problem:
Any Other Relevant Information:
Have You Tried Any Other Therapies For This Condition?
Known Background:
Daily Routine:
Feed:
Treats/Supplements:
Turnout/Excercise:
Worming Regime:
Vaccinations?
Possible Allergies:
When Was Your Animals Last Dental Check?
Any Eye Discharge?
Temperament:
If Female, Has This Animal Ever Had a Litter/Foal?
If So, What Age Were The Young Weaned?
Any Stereotypical Behavious?
Please Include Any Other Relevant Information:
Please Indicate whether you, or anyone else that may be involved with the aromatics could be pregnant, breast-feeding, has a history of high blood pressure, epilepsy, or is taking anti-coagulant drugs?
If Yes, Please Provide Details:
To maintain professionalism and promote a wider understanding and acceptance of Aromatics, I strongly recommend that you inform your Veterinary surgeon that your animal is to be offered Aromatics on a self-selection basis only. Should they wish to discuss any aspect of this therapy, they should contact me. It is important to note that most oils / extracts used have not been formally drugs tested, therefore Aromatics should be treated in the same manner as prescription medication. It is recommended that they should not be offered at least 10 days prior to any competition participation. I understand that the purpose of this consultation is for Leigh to educate me how best to use Animal Aromatics, and The Ingraham Method in a safe manner, on my own animals.
