First Name *

Last Name *

Email *

Phone *

What Brings You to WildHeart?

What problem are you hoping to solve or improve? *

Open text — emotional challenges, focus issues, confidence, trust, PTSD symptoms, overwhelm, etc.

Is there anything important we should know before your first visit? *

Comfort level with animals, past experiences, fears, triggers, safety notes — answer only if comfortable.

What is your main goal for equine therapy? *

Confidence, grounding, emotional stability, trust-building, regulation, connection, routine, etc.

Is this assessment for: *

Please specify:

Has the person ever been around horses before? *

This helps choose the right horse and structure.

Do you prefer shorter, calm sessions or sessions with more interaction? *

Scheduling Preference

How would you like us to follow up to book your assessment? *

How did you hear about WildHeart? *