Thank you for your interest in Headin Home Equine Therapy. We pride ourselves in the pursuit of our mission, “Humans Helping Horses, Helping Humans”. The purpose of this form is to help us get an understanding of where you are at in your life, and what you are hoping to accomplish by utilizing our program, so that we can help empower you and enable to you live a better life through equine therapy.

Please fill out the following form  to the best of your ability and one of our certified therapists will reach out to you with the next steps.

Patient Information

How did you hear about Headin' Home Equine Therapy?

Do you have any present or former health or mental diagnoses contributing to your presentation?

Do you have any current or past substance abuse issues?

Are you currently seeking therapy treatment due to legal charges?

Thank you for your interest in being a part of our Equine Therapy Program. Once you have submitted this form a member of our therapy team will be in touch with you. We look forward to working with you!