New Customer Registration Form
Uncle Tom's Pet Services
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
How did you hear about us?
*
Please Select
Instagram
Facebook
Referral
Other
Please Specify for Referral/Other
Does your dog(s) have any medical issues/concerns? If so please specify
*
Does your dog(s) have any behavioral issues/concerns? If so please specify
*
Primary things to note: aggression issues and guarding issues.
Is your dog protected against fleas and ticks?
*
Ticks are an unfortunate resident of the forest and while I do tick checks/removals post hike, I want to make sure my pack is fully protected just in case
What level of off-leash training does your dog have? Are they e-collar trained?
*
All new dogs are subject to an on-leash trial period until they demonstrate strong engagement with me.
What are your dog's primary motivators? (praise, treats, toys, dogs, prey, etc)
*
Is your dog spayed/neutered and current on all vaccinations?
*
Both are REQUIREMENTS to participate in Uncle Tom's Pet Services and proof of current vaccinations is required.
Is your dog a potential flight risk?
*
Dogs that are known to run away if given the chance can join in the fun on a trial basis. They are kept on leash primarily but may be allowed off-leash in fenced-in areas only.
Pet(s) Name:
*
Name
Name
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