Equine Therapy Safety Checklist/Risk Assessment (Per-Session)

Equine-Assisted Therapy Pre-Session Safety Checklist & Risk Assessment

(Complete immediately before horse–participant interaction. Favor structured fields, checkboxes, and brief entries. If any item is not assessed, document the reason and treat as elevated risk; reflect in Risk Summary and Session Decision.)

Participant and Session Details

Participant: [Name]

DOB/ID: [DOB or program ID]

Date: [Date]

Time of Safety Check: [Time]

Location: [Facility name and specific area]

Session Type: [Mounted / Unmounted / Driving / Vaulting / Mixed]

Lead Clinician/Instructor: [Name and role]

Participant Readiness – Medical/Physical

(Document changes since last session. For each category, indicate Yes/No/Unable to assess. If Yes, provide brief details. If unable to assess, note the reason.)

• New injury or pain affecting participation: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Recent illness, fever, or respiratory symptoms: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• New surgery, procedure, or wound concerns: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Medication changes affecting alertness, balance, coordination: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Seizure activity changes: [Yes / No / N/A / Unable to assess] – [Details if Yes; reason if Unable]
• New or worsening allergies or asthma: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Dizziness, syncope, chest pain, or shortness of breath: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Skin integrity concerns on contact surfaces: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Fatigue, sleep deprivation, or dehydration: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]

Precautions/contraindications reviewed for today: [Yes / No]

Precaution/contraindication details: [Finding identified, contact made if applicable, modifications planned, stop criteria; or N/A] (If contraindication present, specify whether session modified to alternative activity or canceled, with rationale.)

Participant Readiness – Behavioral/Cognitive

• Able to follow safety commands (stop, hands, lean, emergency cue): [Yes / No / Unable to assess] – [Details if No; reason if Unable]
• Emotional regulation sufficient for equine proximity: [Yes / No / Unable to assess] – [Details if No; reason if Unable]
• Aggression or impulsivity risk today: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• Elopement or wandering risk: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]
• New fear or anxiety about horse or environment: [Yes / No / Unable to assess] – [Details if Yes; reason if Unable]

Communication method: [Verbal / AAC / Gestures / Caregiver relay]

Safety-relevant statements: [Direct quotes affecting safety, or N/A] (Use brief direct quotes; if not assessed, state reason.)

Helmet and PPE

Helmet worn: [Yes / No / N/A – unmounted only]

Certification label present: [Yes / No / Unable to verify]

Fit check performed: [Yes / No] (Level position, chin strap fastened, no visible damage.)

Non-standard helmet documentation: [Reason, authorizing clinician, alternate protection plan; or N/A] (Include only if non-standard helmet use is permitted by policy.)

Other PPE and clothing:

• Appropriate footwear (closed toe, stable sole): [Pass / Fail / N/A] – [Notes if Fail]
• Weather-appropriate clothing and long pants: [Pass / Fail / N/A] – [Notes if Fail]
• Medical devices secured (pumps, braces, tubing): [Pass / Fail / N/A] – [Notes if Fail]
• Loose items and jewelry managed: [Pass / Fail / N/A] – [Notes if Fail]

Environment and Site Conditions

Weather conditions: [Temperature, precipitation, wind, ground/footing condition]

Lightning/thunder risk: [Clear / Monitor / Stop – shelter plan activated]

Heat risk: [Yes / No] – [Mitigation if Yes: shade, breaks, hydration, reduced intensity]

Arena/site hazards check:

• Gates latched and perimeter secure: [Pass / Fail]
• Mounting area condition acceptable: [Pass / Fail]
• Obstacles and equipment safely positioned: [Pass / Fail]
• Noise, spectators, and animals controlled: [Pass / Fail]
• Emergency vehicle access clear: [Pass / Fail]

Hazards and mitigations: [Hazard identified and mitigation implemented, or N/A]

Equine Selection and Readiness

Equine ID: [Name/barn ID]

Assigned use: [Mounted / Leadline / Ground work]

Pre-use visual check completed: [Yes / No]

Signs of lameness or illness observed: [Yes / No] – [Brief description if Yes]

Behavior concerns observed: [Yes / No] – [Brief description if Yes]

Equine matched to participant size, skill, and clinical needs today: [Yes / No]

Alternate selection or plan change: [Details if mismatch or concerns identified, or N/A]

Tack and Equipment Check

(Mark N/A for items not applicable to today's session type. If any check not performed, document reason and treat as elevated risk.)

Mounted sessions:

• Saddle fit and placement: [Pass / Fail / N/A]
• Girth secure and billets/latigo acceptable: [Pass / Fail / N/A]
• Stirrups and leathers secure: [Pass / Fail / N/A]
• Bridle, bit, and reins condition acceptable: [Pass / Fail / N/A]
• Quick-release or safety mechanisms functional: [Pass / Fail / N/A]
• Adaptive tack fitted correctly (handles, surcingle, straps): [Pass / Fail / N/A]

Unmounted/ground-based sessions:

• Halter and lead rope condition acceptable: [Pass / Fail / N/A]
• Grooming tools appropriate and participant positioning safe: [Pass / Fail / N/A]

Transfer equipment:

• Mounting ramp, lift, or steps inspected and stable: [Pass / Fail / N/A]
• Wheelchair brakes confirmed: [Pass / Fail / N/A]

Equipment variances or issues: [Details, or N/A]

Team Staffing and Briefing

Roles assigned and present:

• Lead clinician/instructor: [Name, role]
• Equine handler/leader: [Name, role]
• Side walker(s): [Name(s), role(s), or N/A]
• Additional staff/volunteers: [Name(s), role(s), or N/A]

Participant support level: [Number of side walkers/spotters planned]

Briefing completed: [Yes / No]

Key briefing items:

• Stop signal or emergency cue word: [Cue documented]
• Emergency dismount plan and who initiates: [Plan documented]
• If-then triggers for pause or stop: [Triggers documented]

Risk Summary

Identified risks today: [List each identified risk on separate line, or "No significant risks identified"]

Controls implemented: [List control mapped to each risk above]

Residual risk level: [Low / Moderate / High]

Stop criteria for today: [Specific triggers that prompt pause or termination]

Session Decision

Decision: [GO / GO WITH MODIFICATIONS / NO-GO]

Modifications: [List modifications, or N/A] (Include only if GO WITH MODIFICATIONS.)

Alternative offered and notifications: [Alternative provided, names/roles notified, and time; or N/A] (Include only if NO-GO.)

Rationale: [Key risk drivers, mitigations in place, and why this decision represents the safest reasonable option today] (If proceeding despite notable risk, include risk-benefit reasoning and monitoring plan. 2–4 sentences.)

Sign-Off

Author: [Name, role/credentials]

Time signed: [Time]

Co-signature: [Name, role/credentials; or N/A] (Include if required by program policy.)

Late Entry / Addendum

(For corrections or additions after initial completion. Omit section if not applicable.)

Date/Time: [Date, Time]

Author: [Name, role/credentials]

Addendum details: [What is corrected or added and reason]