EmailMe Form - New Client Intake Form: Calling All Dogs

Name

First Last

Name of second owner

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email

Phone

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

Please list names and ages of all members of the household, including pets.

Dog's Name *

Breed *

Age / Gender *

Spayed / Neutered? *

What is your MAIN reason for a consultation? *

What else would you like to work on? *

Has your dog ever bitten / injured a person or animal? If yes, please explain each incident in detail. *

How does your dog react to strangers entering the home? *

If aggression related, when does your dog display this behavior? *

Please list any previous training done. *

Meals are: *

Scheduled

Free-fed

What brand of food does your dog eat? *

Does your dog have food allergies? If yes, please list: *

Please explain the type and frequency of his/her exercise, as well as equipment used on walks. *

Is there anything else you would like us to know?

Lesson Time Preference

Evenings during the week

Afternoons during the week

Preference of Location

Facility

Home

Either

*

I agree to the above terms.

By checking the box above, I understand that advanced payment for the lesson is required.

The payment is non-refundable but may be transferred to a different date as long as 48 hours notice is provided prior to the original appointment date. The non-refundable payment may only be transferred once.