Please fill in our form and submit. Or you can download this form here and send to us via fax or mail.

Name:
Address:
City:
Postal Code:
Phone Home:		Work: Cell:
Email address:
Dog's name:		Male/Female:
Dog's Birthday:		Dog's Age:
Breed/Mix of Dog:

Behaviour Challenges	Yes	No	Notes
Housebroken
Anxious when you leave
Jumps on people at front door
Jumps on kids in the house
Steals food off the counter
Begs at the dinner table
Excessive barking
Uncontrolled digging
Chewing furniture/shoes
Bites or nips people
Growls near food bowl
Growls while on couch/bed
Walking on leash politely
Come when called
Basic commands - Sit, Down, Stay

Behaviours you want to work on/solve (Wish List):
Goal 1:
Goal 2:
Goal 3:
Goal 4:
Other Notes:

Preferred Training Times:
Weekday mornings		Weekday afternoons		Weekday evenings
Weekend mornings		Weekend afternoons

Referred by:

Budget:	maximum $ (optional)

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