Praying Hands Ranch Application

FORMS

Prospective Client Registration Form

Thank you for your interest in our Ranch programs. If you think you may have signed up in the past for Promise or Praying Hands Ranches (for any service), please contact our Business Manager at 303-841-4043 and we can update your record instead of creating a duplicate.

One form per client.

So we can customize your questions, please answer these questions before continuing:

Programs You are Intested In? Check all that apply Not sure what a service is, just hover over the service title.	Adaptive Horsemanship Horsemanship and riding lessons adapted to the client’s ability Equine Assisted Therapy (aka Hippotherapy) Physical, Occupational, or Speech therapy while horse-mounted Equine Assisted Learning An experiential learning technique that facilitates personal growth by teaching social, emotional, and life skills through horsemanship Mental Health Psychotherapy with an equine partner where appropriate Music & Movement TherapyThe use of music and movement to improve physical and emotional health. Supported Employment Prevocational training, Job Development, and Job Coaching for adults with intellectual disabilities. Veterans Programs Description of Service
Are you completing this form for yourself?	Yes No
Is the Client covered under a Community Based Provider?	Yes (Developmental Pathways, Rocky Mountain Human Services) No
Do you have insurance that may cover your services(s) - NOTE: Adaptive Riding Program is not eligible for Insurance	Yes No
Does the Client have a current ABA Provider?	Yes No