Wufoo

Your Dog's Name:
Your dog's present age & approximate weight: *
How old was the dog when you got it:
Is you dog a male or female? *
Breed of Dog *
Check ALL of the issues you are having with your dog: *
Jumping on People Pulling on the leash Aggression toward people Not Housebroken Excessive barking Aggression towards Dogs Destructive Behavior Fearful Inappropriate Mouthing
Are there any other issues that you are having that are not listed above, please list them here:
Please tell us as much information as you can about your dogs aggression towards people:
Please mark any and all training devices you have tried or are using now:
Prong/Pinch Collar Choke Collar Harness Head Halti / Gentle leader Flexi / Retractable leash Electronic Collar
Where did you get your dog:
What training has your dog had and where?
Has your dog EVER growled, snapped, nipped, shown teeth, or bitten you or anyone else?

If yes please explain.... *
Now for some information about you and your family:
Your Name: * First Last
Email *
Best number to reach you if needed: * ### - ### - ####
Alternate phone #: ### - ### - ####
Town you live in: *
Please check any of the statements that best describes your emotional state surrounding your dog: We love him/her *
and would never think of give my dog up. but his/her behavior is causing our family stress. but we are honestly wondering if we can keep our dog. and have come VERY close to taking our dog to a shelter. but the dog is ruining our life/home/marriage
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Who do you use as your regular vet? *
Please tell us how you heard about us: *
When would the Best day/time be for us to come to you, i.e, Monday nights, weekends, etc:
Do you have Children, if yes please give us their ages? *
Is this your first dog?
Yes No No but it has been a while!
Just a little bit more about your dog:
Other questions about your dog: Please check any and all that appl.
My dog and I use a dog park. My dog has an enclosed yard (above or below ground). My dog is housebroken. My dog uses a crate.
Other informations: Please use this section to tell us anything else you feel we should know about your dogs issues:
Do Not Fill This Out

Wufoo

Now for some information about you and your family:

Just a little bit more about your dog: