Client Information
Information about the owner(s) of the pet requiring training/boarding
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Second Owner Information
If another person will be attending training sessions, you must list their information here.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Information:
Please list someone other than yourself. This is the person we need to contact in case we cannot reach you during an emergency.
Emergency Contact: Name
*
First Name
Last Name
Emergency Contact: Phone Number
*
Please enter a valid phone number.
Pet's Information
Tell us everything about your pet!
Pet's Name:
*
Pet's DOB:
*
/
Month
/
Day
Year
Date
Breed:
*
Color:
*
Sex:
*
Neutered Male
Intact Male
Spayed Female
Intact Female
Which veterinary clinic do you take your dog to?
*
Island to Island
Stonetree
Other
If other, please explain
How long have you had your pet?
*
From where did you obtain your pet?
*
Please Select
Breeder
Shelter
Friend/Family
Is/Was your dog crate trained?
*
Yes
No
Is your dog house trained?
*
Yes
No
How many hours is your dog accustomed to spending in a crate on a daily basis?
*
Have you done any training with your dog before?
*
Yes
No
If yes, please describe what commands they may know:
*
Please explain your dog's eating routine:
*
Please explain your dog's daily routine:
*
Does your dog have any food allergies?
*
Yes
No
Please list the allergies:
*
Does your dog suffer from any chronic illnesses or any medical conditions?
*
Yes
No
Please list and explain chronic illnesses or any medical conditions:
*
Is your dog on any medications?
*
Yes
No
Please list and explain medications:
*
Has your dog had any previous injuries that I need to be aware of?
*
Yes
No
If yes, please describe previous injuries:
*
Does your dog do well with other dogs?
*
Yes
No
If your dog does not do well with other dogs, please describe:
*
Does your dog show food aggression towards other pets?
*
Yes
No
If your dog shows food aggression towards other pets, please describe:
*
Does your dog do well with other people?
*
Yes
No
If your dog does not do well with other people, please describe:
*
Does your dog guard objects or food from people?
*
Yes
No
If your dog guards objects or food from people, please describe:
*
Has your dog ever growled at a person?
*
Yes
No
If your dog has growled, please describe:
*
Has your dog ever snapped at a person?
*
Yes
No
If your dog has snapped at a person, please describe:
*
Has your dog ever bitten a person?
*
Yes
No
If your dog has bitten a person, please describe:
*
Does your dog have any behavioral Issues?
*
Yes
No
What issues/behaviors are you experiencing and wanting to work on?
*
Which type of service are you interested in?
*
Board and Train
Board
Private Sessions
Group Classes
Day Boarding *coming soon
Partial-Day Training *waitlist
Does your dog have a valid borough-issued pet license?
*
Yes
No
Upload Pups Pet License Tag & License (must show expiration dates)
*
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Required by the Ketchikan Borough, must obtain directly with Ketchikan Animal Protection Services.
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Upload Pups Full Veterinary Records
*
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Records MUST show proof of: Rabies, Bordatella, Parvo, Worm prevention, and Flea prevention. If your dog is missing any of the above mentioned, submit the records you currently have, and send the most up-to-date record when obtained to revival.k9.scheduling@gmail.com
Cancel
of
Send us your pup's best picture!
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Choose a file
Feel free to send us your pup's best picture for their file!
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of
Would you like to to be added to our mailing list to receive the Revival K9 Weekly Newsletter?
*
Yes, I do not want to miss any updates!!
No, thanks!
Verification of Age:
I confirm that I am at least 18 years of age and eligible to participate in the dog training program.
Submit
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