Prior to your first NDIS Session, please complete the following form which provides us with the information to tailor a package which is both appropriate and safe. This will also be used to create an account in our system should you wish to continue with regular sessions. Please also refer to our Privacy Policy.

Client

Person with disability

Please use format DD MMM YYYY (eg. 6 Aug 1995)

For horse riding we need an approximate weight in order to select an appropriate horse. Enter the number of kgs.

Responsible Person

Name of parent, guardian with primary care responsibility for the client

Please indicate your relationship to the client. This might be parent, child, guardian, carer, support coordinator, etc.

Select which payment options apply for your first and potentially regular sessions. Tick all that might apply. Note that for regular invoiced sessions (limited availability on Saturdays) you will need to request a regular booking by email preferably covering three months in advance.

Regular Carer

Contact details of regular carer who will accompany the client

Tick yes if a regular carer will accompany the client for each session

Plan Manager

Who is responsible for administering your NDIS plan and payment of invoices

Which of the three available options are you using to manage your NDIS plan - refer https://www.ndis.gov.au/participants/creating-your-plan/ways-manage-your-funding

Invoices will be sent to the primary contact
NOTE: We are currently NOT able to host clients with a NDIA-managed funding plan. Please continue to submit this form if you would like to register your interest in our program. We will contact you when we are able to invoice the NDIA directly and offer our services to you.

Medical and Behavioural Issues

Please supply as much information as possible to ensure that we can tailor an appropriate and safe program for the client.

Please provide a description of any known medical issues that could lead to problems in a farm environment. Include Known conditions for which medication is given regularly, bleeding abnormalities, allergies, physical disabilities, etc.

Please provide details of any tendencies that would not be regarded as "normal" such as anxiety, reactions to events, tendency to run/hide, phobias, etc.

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