Merit Dog Project

Dog Behaviour Consultation Intake Form
EMAIL: erin@meritdogtraining.com

FACEBOOK: @MeritDog WEBSITE: www.meritdogtraining.com
Name

First Name Last Name
Phone 1:
Phone 2:
E Mail Address:
example@example.com
Address:
Family members participating in training (name and age):
Other pets in house?:
DOG INFORMATION:
Dog's Name:
Breed:
Current age:
Sex:
Age Neutered/Spayed:
Age Aquired:
Age left litter:
Veterinary Clinic:
Where from & why:
Groomer:
Kennel/Daycare:
Health History:
Is he/she on any medication?:
Diet History:
Current Food:
Duration on this food:
Feeding schedule:
Where is he/she fed?:
Sleeping area:
How would you describe his/her personality?
Has your dog ever bitten anyone? If yes, please explain.
Is your dog scared/fearful of anything? (example: noises, strangers, the car etc.) Please be as specific as you can.
TRAINING INFORMATION:
Current forms of praise & discipline:
Previous Professional or Alternate Resources and Training or classes:
Current Behaviour Issues – please write a short description of why you are seeking help with your dog, what behaviour issues you are seeking help for, and how long these issues have been occurring.
Goals:
1.
2.
3.
4.
5.
6.
If you are choosing an online/remote behaviour consultation option (NOT in person), what is your preferred chat option?

Zoom Skype Google Team WhatsApp
Please indicate the service that you would like to purchase. You will receive an invoice via PayPal which must be paid before your initial consultation.
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Package One $ 465.00 NZD
Initial consultation plus one follow-up session.

Quantity

Package Two $ 750.00 NZD
Initial consultation (90 minutes) plus 3 one-hour sessions.

Quantity

Package three (for separation anxiety cases ONLY) $ 750.00 NZD
Includes initial consultation, one 60-minute follow-up and ten 15-minute remote sessions. Ongoing email support provided for the duration of the package. Includes a detailed schedule for tracking progress.

Quantity

Initial Consultation $ 325.00 NZD
Initial consultation only (90 minutes). This is a pay as you go option and it is expected that you will need following sessions.

Quantity

Total $ 0.00 NZD
I appreciate referrals. Where did you hear about Merit Dog Project's services?
Details of client services: The initial consultation is approximately 90 minutes long and include an evaluation and plan. Sessions are 1 hour and include the application of our plan and training/behaviour modification depending on your goals and your dog's needs. Packages ay be purchased in advance. Payment details will be provided to you. If you cannot make your allotted time, you must provide me with an email 24 hours in advance in order to receive a refund/rescheduled time. Please acknowledge you have read and you agree with the above terms.

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Dog Behaviour Consultation Intake Form

DOG INFORMATION:

TRAINING INFORMATION:

Goals: