Information Request Form

Owner Information
Name First Last
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone - (###) - ### ####
Cell Phone - (###) - ### ####
Email *
Dog Information
Name
Birth Date / MM / DD YYYY
Breed
Color
Gender
Neutered Spayed
TRAINING/BEHAVIOR INFORMATION
How long have you owned your dog?
Did you rescue or purchase from a breeder?
Characterize your dog's temperament (shy, reserved, energetic, etc.)?
Explain how your dog interacts with people.
Is your dog partial to men or women? Men Women
Describe how your dog interacts with other dogs?
Does your dog have any known health issues?
How much daily exercise does your dog get (leash walk, off-leash walk, ball, etc.)?
Do you use or plan to use any kind of electrical training devices? (invisible fence, remote collar, bark collar, etc.)
Does your dog use a crate? Yes No
Does your dog walk well on a leash? Yes No
List your training expectations.
Is there anything else you would like me to know about your dog?

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