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Veterinary Consent to Bodywork

Please make sure this form is forwarded to your horse's veterinarian to fill out prior to their first session.

IMPORTANT: I (Michelle Oztum/Vitalis Bodywork) am an equine massage therapist and myofascial release practitioner. As a supportive part of a horse's care team, my role is to help improve comfort, mobility, and performance. I do not adjust horses, and I cannot diagnose, treat, or prescribe.

Client Details

Owner’s Name

Horse’s Name

Horse’s Sex

Horse’s Age

Veterinarian Details

Veterinarian Name

Practice Name

Practice Phone Number

Veterinarian Consent

Please list any relevant medical history.

Any additional relevant details or documents can be sent to Vitalis Bodywork at vitalisbodywork@gmail.com

By signing this form, I as the client’s veterinarian confirm that the client’s horse has no indications that would contradict bodywork or massage therapy.

Signature

Date of Signature