Hippotherapy Application

What is Hippotherapy?

Hippotherapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse to provide carefully graded motor and sensory input. A foundation is established to improve neurological function and sensory processing, which can be generalized to a wide range of daily activities. Unlike therapeutic horseback riding, the movement of the horse is a means to a treatment goal when utilizing hippotherapy as a treatment strategy.

Medical History

Client must have a physical or mental health condition to apply for STAT®️'s Hippotherapy program. This is not horseback riding lessons, sessions are facilitated by a licensed Physical Therapist.

PLEASE TYPE DIAGNOSIS IN BOX ABOVE

The applicant understands that a medical or mental health diagnosis is required for Hippotherapy

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Client Information

First name

Last name

Age

Date of birth

Check this box if the client is a minor or has a legal guardian

Email address

Contact phone number

Parent or Guardian Information

First name

Last name

Home phone number

Cell phone number

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Relationship to child

Is the client currently under the care of a medical provider or is there anything else of importance that you want to tell us? Please describe below.

A staff member will be in touch. If you have questions, please feel free to contact STAT®️ at 833-328-7828 or via email at cmarkosky@statinc.org.

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Hippotherapy Application

What is Hippotherapy?

Medical History

Client Information

Parent or Guardian Information

What is Hippotherapy?

STAT® Inc.

Healing With Horsepower since 2007