When you click “submit,” the form should come to us.  If you do not hear back within two days, please text or email to make sure we received it. 

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

    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/Intact?* SpayedNeuteredIntact

    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

    Has your dog ever bitten, growled at, lunged at, or behaved aggressively towards anyone or any other animal? 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?*

    Has your dog every bruised, scratched, nicked, or otherwise injured anyone or any other animal? If so, what were the extent of the injuries? What has been done to work on the problem.*

    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*

    Is this behavior change recent? Does it occur during handling, petting or moving the dog? Does your dog have ear or skin issues? Is your dog on medication?*

    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?