If your child and family would benefit from the programs at Angel Heart Farm, please click the button below to download or complete the Angel Heart Farm Form titled “Participant & Physician Form”.

Once you have filled out this form, please be sure to send a copy to yourself to share the completed form with your child’s physician. Or request your child’s Physician to complete the form online using the button labeled “Physician’s Statement Form”.

To download/print the forms and complete manually click this link.

Please submit manually completed forms to Tracy Kujawa at angelheartfarm@gmail.com.

Your patient is interested in participating in equine assisted therapies and related services. In order to safely provide these services and work together to better support your patient Angel Heart Farm is requesting a Physician Statement along with basic diagnostic, medication and treatment plan information.

Please click the button below to complete online or download the Physician’s Statement Form can complete manually.

Please submit manually completed forms to Tracy Kujawa at angelheartfarm@gmail.com.