Home Ever After – Horse Assessment Form Thank you for starting the journey of safeguarding your pet’s future welfare. By enrolling your furry friend in the Home Ever Program you will ensure your pet is always looked after come what may. To complete this form you will need to have to hand the following items: Your pet’s microchip number Your vet’s contact details Your pets medication details, if applicable Your pet’s vaccination record Your breeder’s details, if applicable We anticipate the form will take 20 minutes to complete. You can save the form and come back later if necessary too. If you have any questions about the form, please contact the Home Ever After team on 02 9782 4419. 1Personal Information2Vet Details3Horse Information4Environment/Lifestyle5Family Relationships6Aggression7Can we?8 Personal InformationName* First Last Address* Address line 1 Address line 2 Town/suburb State Postcode Email* Phone: HomePhone: Mobile*Preferred method of contact Mobile Home Best time to contact Morning Afternoon Evening Second owner's details if any First Last Email PhoneYour HEA Agreement form must be witnessed, please provide their details:* First Last Email* Address* Address line 1 Address line 2 Town/suburb State Postcode Vet DetailsClinic* Name Vet First Last Address* Address line 1 Address line 2 Town/suburb State Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone Horse InformationName First Date of birth MM slash DD slash YYYY Breed Weight Sex Gelded? Yes No If yes, when? Microchip Number Colour Distinguishing Features Medications? Please SpecifyVaccinations Due/WhenRegistered with council or an equestrian organisation? Yes No Where did you obtain this horse? Breeder (if applicable) Environment/LifestyleFor what purpose did you get your horse? Companion Show Breeding Working Age Obtained FeedingType of food Amount Fed Frequency of feeding When fed and where? Who does the feeding? (describe eating) Favourite treat Supplements given Play/ExerciseFavourite game Type of exercise Amount/Frequency of exercise Amount/Frequency of play Favourite Toy(s) Is your horse used to being ridden? What sort of yard does your horse live in? Day to Day CareIs your horse shod? If so how often? Does your horse get rugged? If so in both summer and winter? Do you use a fly veil on your horse? Do you adjust your horse with other horses? Is your horse stabled? Family RelationshipsList family members (include sex and age) who have a relationship with the horseWhich family members have the best control?Which family members have the least control?List all other pets including breed, age and sex:Describe how your pets get along with each member of the family and each pet:Briefly describe your horse's personality: HandlingHow does your horse react to the following? Hoof Trimming Being haltered or bridled Being saddled Cleaning Ears Giving Medication Grooming/Bathing Petting Being floated Other animals AggressionIs your horse aggressive toward family members? Yes No If yes, how Is your horse aggressive toward other people? Yes No If yes, how Has your horse ever bitten hard enough to break the skin or cause injury? Yes No If yes, under what circumstances did this occur? How long ago? Was there an illness or health problem when the aggression started? When your horse is aggressive what is your response? Additional Comments Can we….Re-home with children? Re-home with another horse? Re-home with male/female? Needs a quiet home? Anything else you would like to share?Phobias/ sweet characteristicsAdditional CommentsPlease attach a photo of your horseMax. file size: 64 MB.Consent* By clicking on the submit button, you declare that you are the legal guardian of the pet and the information you have provided is accurate and true as of today’s date.
