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YOUR INFORMATION

First Name*
Last Name*
Introductory Message*
Email*
Phone*
Type* CellHome
Preferred Contact Method* PhoneEmailText
Address*
Number of people in household*
Names of other adults in Household
Children still at home, names and ages

DOG'S INFORMATION

Dog's name*
Dog's age*
Dog's weight (approx)*
Dog's sex* MF
Spayed/Neutered?* SpayedNeutered
Dog's breed or mix*
How long have you had your dog?*
Where did you get your dog?* RescueShelterBreederFriend/AcquaintanceOther
Shelter, rescue or breeder name
Dog's age when acquired
What information, if any, do you have about his/her previous life?
Other animals in household
Your experience level* First time ownerSomewhat experienced (have had a few)Very experienced
Please describe your dog's behavior problems, in as much detail as you wish*
How often and in what context do the behavior problems occur?*
What has been done to work on the problem(s)?*
Do you know whether your dog ever suffered a traumatic event? An attack by another dog or an issue with a human? If so, please explain
Veterinarian*
Does your dog have any known physical problems?*
Is your dog on any medication? If so, please list them*
What kind of food do you give your dog?*
Where does your dog sleep?*
What kind of exercise does your dog get on a daily basis?*
Has your dog had any formal training?* NoBasic ClassesAdvanced or Specialized ClassesPrivate Trainer in homeBoard and Train
Does your dog go to daycare or have a dog walker?*
Activities and food your dog likes*
How long is your dog typically left alone?*
What makes your dog get excited?*
What are your goals for your dog?*
Where did you hear about our services?

Note: Please fill out the fields marked with an asterisk*