Consultation Form Consultation Sign Up! Name: Email: Phone number: Address: How did you find us? If referred by someone, who should we thank? Dogs Name(s): Dog's age Dog's breed or mix: Dog's Sex: Please Select One Male Female 11. Spayed/Neutered Please Select One No Yes What type(s) of training are you interested in? (Please check all that apply). Puppy Training Basic Obedience Intermediate Obedience Advanced Obedience Behavior Modification Trick Training Task Training Anxiety/Fear Aggression/Reactivity Special Request Which training options interest you? (Please check all that apply). Private Training - Single Private Training - Package In Home Group Class Day Training Package Video/Phone Training FB Messenger Q&A Email Q&A Perferred start date? Minimum number of lessons you're interested in? Behaviors you would like addressed or taught? (Please be as thorough as possible). Does your dog have any dietary restrictions, health concerns or allergies, including food allergies? Please explain. Has your dog ever bitten or attacked a PERSON, or attempted to? (Excluding gentle play mouthing). Please Select One Yes No If yes, how many times have they bitten and drawn blood? If yes, how many times have they bitten and NOT drawn blood? If yes, what happened? What was the extent of the damage? Has your dog ever bitten or attacked a DOG? (Excluding gentle play mouthing). Please Select One Yes No If yes, how many times have they bitten and drawn blood? If yes, how many times have they bitten and NOT drawn blood? If yes, what happened? Is your dog prey driven? (Please check all that apply). Yes, attempts to chase cars, bicyclers or runners. Yes, is highly distracted by small animals. Yes, has caught or killed cats, squirrels, birds, chickens or other prey. No, only to a small degree or not at all. In addition to the behaviors you are seeking training for, does your dog have any other behaviors that would be beneficial to know about? Such as shyness/fearfulness, trauma, history of aggression/resource guarding, mounting, self-destructive tendencies, refusal to get off furniture, or other. Please Select One Yes No If yes, please explain. Has the dog had previous training? Please Select One Yes No If yes, please include what was taught and whether it was taught in a class setting, as a private lesson, or by the owner. General availability for training? (Please check all that apply. Checking does not commit or guarantee availability). Monday (9am-10am) Monday (10:45am-11:45am) Monday (12:30pm-1:30pm) Monday (2:15pm-3:15pm Monday (4pm-5pm) Monday (6pm-7pm) Tuesday (9am-10am) Tuesday (10:45am-11:45am) Tuesday (12:30pm-1:30pm) Tuesday (2:15pm-3:15pm Tuesday (4pm-5pm) Tuesday (6pm-7pm) Wednesday (9am-10am) Wednesday (10:45am-11:45am) Wednesday (12:30pm-1:30pm) Wednesday (2:15pm-3:15pm Wednesday (4pm-5pm) Wednesday (6pm-7pm) Thursday (9am-10am) Thursday (10:45am-11:45am) Thursday (12:30pm-1:30pm) Thursday (2:15pm-3:15pm Thursday (4pm-5pm) Thursday (6pm-7pm) Friday (9am-10am) Friday (10:45am-11:45am) Friday (12:30pm-1:30pm) Friday (2:15pm-3:15pm Saturday (9am-10am) Saturday (10:45am-11:45am) Saturday (12:30pm-1:30pm) Saturday (2:15pm-3:15pm Would you prefer a FREE phone consultation or 25% off your first session as your initial consult? Please Select One FREE Phone Consultation Discounted first session Submit
