Preliminary Separation Distress Email Questionnaire

Preliminary Separation Distress Questions

Deb Manheim, CSAT. Happy Tails Family Dog Training debmanheim@gmail.com
Your Name*

First NameLast Name
E-mail*
Confirm Email*
Phone Number (with text)*

Area CodePhone Number
Your Location (City, State)*
Dog's name / Gender / Age*
Breed or mix?*
Where dog was acquired (breeder, shelter, other)*
How long has your dog been in this household?*
Please describe what your dog is doing that has you concerned.*
How often is your dog being left alone? Please give number of hours (2-4 for ex.)*
Can you adjust your schedules so that your dog is NOT left alone for awhile during training?*
Have you done any training to address your dog's separation related problem? Please explain. *
For how long would you like to be able to leave your dog (in the future)?*
Have you contacted your vet about your dog's separation distress?*
Who is your veterinarian? Name, clinic name, address, phone.
How did you hear of us?*
Contract:

I, (We), ________________________________________________________ will suspend absences so that my dog ______________________will not experience any duration of alone time while participating in this training program. By not suspecting absences, your dog will very likely regress in progress and sensitize rather than desensitize.

I, (We), understand that a breach in this contract may undermine any training that you have worked on with Happy Tails Family Dog Training, Deb Manheim, CSAT, and that no refunds will be given.
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Preliminary Separation Distress Questions