Appointment Request Form

Educational Package Request

Please complete all the information below so we can provide you and your dog with the best service possible.
Full Name *

First Name Last Name
Phone *

Area Code Phone Number
E-mail *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
What pick up day works best for you? *

Monday Tuesday Wednesday Thursday Friday Saturday
What pick up time works best for you? *

Morning Afternoon Evening
Any specific date/time?

Month Day Year Hour Minutes AM/PM Option
What are 3 changes you would like to see after training is completed?

How much time are you willing to invest in your dog each day? Each week?
What do you like about your dog?
What about your dog frustrates you?
What have you attempted so far to remedy these frustrations?
Would you consider your dog destructive? If yes, please provide an example.
Do you think your dog receives adequate exercise? Please provide examples and how often it occurs.
What food do you feed your dog; how often are they fed?
Do you know what mental stimulation/exercise is? If yes, how do you provide that and how often?
Are you open to setting more boundaries in your home with your dog in order to improve your relationship?
How many people in your household are actively involved with your dog?
Are there any other people outside of the household actively involved? Ex: dog walkers, pet sitters, doggie daycare etc.
Do you have any questions about my training methods?
Please tell me your dog's name, age, and breed/mix:
Is your dog spayed/neutered? If so at what age did it occur?
How much time do you have daily and weekly for training and working with your dog?
Are you willing to commit to practicing with your dog and integrating daily training opportunities into your routine?
After training is completed are you willing to follow instructions and utilize the directions given while transitioning your dog back into your home?
Do you understand that training must be continued by you and other family members after drop off, and utilized in your new day to day routine?
Does your dog display any of the following: fear of people/dogs, reactivity towards people/dogs? If so when/where does it happen most often?
Does your dog have any of the following: Kennel stress, seperation anxiety, frantic barking when left alone outside etc? If so please explain when and how often, and how long it has occurred.
For anxiety related issues, are you willing to seek veterinary assistance if suggested by the trainer?
Should be Empty:

Educational Package Request