First name*

Last name*

Street Number*

Apartment*

City*

ZIP*

Phone number*

Additional Number

Veterinarian Name

Veterinarian Number

Dog’s Name*

Dog’s Breed*

Dog’s Age*

Dog’s Weight*

Dog’s Gender*

Dog's Condition*

Any health issues?*

If yes, please explain:

Describe your daily routine with your dog*

How many people live with your dog & what are their ages?*

Do you currently crate your dog?*

Has your dog ever escaped from a crate?*

Has your dog ever jumped over a fence or escaped?*

How does your dog behave with other dogs, cats, other animals?*

How does your dog behave when left alone or when you leave the home?*

How does your dog behave in the car?*

Has your dog ever aggression towards humans? If yes, please give details. *

What is something you do that's fun with your dog or would like to do?*

Want do you want most out of training? What are your expectations?*