New Client Evaluation Form

The K9 House

JESSICA@AK9A.COM

AK9A.COM

(630) 819-0470
New Client Evaluation Form

EVALUATION FORM
OWNER INFORMATION:
Full Name*

First NameLast Name
Address*

Street Address

CityState

Zip Code
Your Phone Number*
Format: (000) 000-0000.
Your E-mail*
Dog(s) name and breed*

nameBreed
Dog(s) Date of Birth or best guess*

MonthDayYear
Date
Photo of dog

Cancelof
Your dogs sex*
2nd dogs name (if no second dog no need to fill out)

nameBreed
Dog(s) Date of Birth or best guess

MonthDayYear
Date
How did you hear about us?*
Evaluation time and day*
Check all that apply*

My dog jumps on guestsMy dog pulls on the leashMy dog is not potty trainedMy dog is not crate trainedMy dog has separtion anxietyMy dog has anxiety/is fearfulMy dog barks at strangers (not aggressively)My dog barks at strangers (aggressively)My dog is a puppy and doesn't know anything yetMy dog runs away when off leashMy dog has bitten someoneMy dog has bitten another dogMy dog has been attacked by another dogMy dog does not like other dogsMy dog does not like strangersMy dog barks at other dogs (just wants to play)My dog barks at other dogs (aggressively)My dog does not follow commands when askedMy dog has poor mannersMy dog does not respect my children or other family membersOther
An evaluation is $65. Payment is required before the date of your evaluation visit. You can pay through the following:

Zelle: jessica@ak9a.comVenmo: jessicak9house
Should be Empty:

The K9 House