EmailMe Form - GAME READY® Professional Kit Rentals

Your Name *

First Last

Your Email *

Your Phone *

### - ### - ####

Are You a Client of The ATLANTA EQUINE Clinic? *

YES

NO

If you are not a regular client of our practice, you may need to provide further information to secure Equipment Rental.

RENTAL REQUEST INFORMATION

Please Choose Your Rental Preference

7-day Rental for $195

14-day Rental for $275

30-day Rental for $475

More than 30 days at $450/month

This information is used for assessing rental availability only. You can change your preference at any time, even during the rental period. There is no limit on duration of rental. Additional fees may apply.

When Would You Like to Reserve Your Unit (Start Date)?

MM / DD / YYYY

How Would You Like to Secure Your Unit?

Please send the Unit via MAIL*

Please have the Unit delivered to my Barn**

I would like to arrange to PICK-UP the Unit

*An additional $95 for Packing & Shipping will be assessed.
**Ambulatory Fees may Apply.

Have you Read the RENTAL AGREEMENT?

YES

NO

A Signed Rental Agreement (which you can download from our website) is required to secure Unit Rental.

Would you like to Purchase Insurance for your Unit?

YES

NO

I'm Not Sure Yet

Insurance is HIGHLY recommended and costs $50 for the Life of your Rental. Please Read the Rental Agreement fot Details.

What is the Purpose for Your Rental?

Trying this Unit before Purchasing my Own

My Horse has a Chronic (Long-term) Injury

My Horse is Recovering from an Acute (Recent) Injury

My Horse is Undergoing Surgery

My Horse has Previously Undergone Surgery

Trying to Prevent Future Injury

Trying to Improve my Horse's Overall Performance

Other

Please Check ALL That Apply.

Would You Like a Veterinarian to Contact You?

Yes

No

We would be happy to address any questions or concerns that you have regarding this treatment modality and tell you if we think that it worth implementing for your horse(s).

How would like us to contact you? *

Via eMail

Via Telephone

Please allow 3-5 business days for us to respond to your request. THANK YOU.

Do you have any Questions, Special Requests or Comments?

RENTAL REQUEST INFORMATION

THANK YOU for Your Interest in GAME READY® Rental from The ATLANTA EQUINE Clinic!