HorseSense for Special Riders is a therapeutic riding program designed to benefit the riders physically, socially, and emotionally. Safety equipment and specially trained horses and volunteers are used in order to assure the fullest possible protection and greatest personal benefit from the program. Each rider is required to furnish the following medical information before being accepted as a rider.
To my knowledge, there is no reason why this person cannot participate in supervised equestrian activities. However, I understand that the therapeutic riding center will weigh the medical information above against the existing precautions and contraindications. I concur with a review of this person's abilities/limitations by a licensed/credentialed professional (e.g. PT, OT, Speech, Psychologist, etc.) in the implementing of an effective equestrian program.
The following conditions, if present, may represent precautions or contraindications to therapeutic horseback riding. Therefore when completing this form, please note whether these conditions are present, and to what degree.
Spinal Instabilities I Abnormalities
Hip Subluxation & Dislocation
Peripheral Vascular Disease Varicose Veins Hemophilia Hypertension
Serious Heart Condition Stroke (Cerebrovascular Accident)
Hydrocephalus I Shunt
Chiari II Malformation
Paralysis due to Spinal Cord injury
Age under two years
Age two - four years
Acute exacerbation of chronic disorder