Customer Evaluation
General Information
Owner's Name
Address
City
Zip
Home phone
Cell
Email
example@example.com
How many members are in your family?
Children?
Ages?
Vet's Name and contact info
Is your dog current on their Vaccines?
How did you hear of me?
Dog's Name
Dog’s Age
Breed
Male or Female
Spay/Neuter
How long have you owned your dog?
What would you like your dog to do for you?
What would you like your dog to stop doing?
Does your dog have any health issues?
Where does your dog sleep?
Is your dog allowed on the furniture?
How do you stop unwanted behaviors in your dog? Do you feel your current method is effective?
Have you worked with any other professional dog trainers?
Please list all other pets you own with their ages and species
What food is your dog eating? Brand and variety please
Exercise Regimen
Behavioral Problems !
Select all that apply
Other bad habits?
Notes
I
have reviewed this information, and to the best of my knowledge, it is correct with no omissions.
Signature
Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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