Initial Rider Physician Statement

Thank you for submitting your Rider Application Packet. Your last step is to download and print the Physician Statement which will need to be completed by the participant’s doctor. Once the physician statement is completed, please email to MTR Program Director, Kelly Rodgers, at kelly@mtrinc.org.

Click here for the Physician Statement

For the participant’s enrolled in Hippotherapy, you will also need to have the doctor complete the Hippotherapy Prescription Form.

Click here for the Hippotherapy Prescription Form

For participant’s that have had seizure activity in the last ten years, you will also need to have the doctor complete an MTR seizure statement.

Click here for the MTR Seizure Statement Form