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Your Information

Name:*

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Last

E-mail:*

Phone:

Area Code

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Phone Number

When is the best time to reach you?*

Day

Evening

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Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Dog Information

Breed:*

Sex:*

Male

Female

Neutered/Spayed:*

Yes

No

From a Breeder?*

Yes

No

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Current Age:

Age of dog when brought home?

If you answered Yes to Breeder question above.

Breeder Name:

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Last

Breeder Phone:

Area Code

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Phone Number

Breeder E-mail:

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Breeder Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Your Dog's Behaviours

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Other (Describe):

Medical Issues

Medical Description:

Previous Training

Have you taken your dog to another trainer for training?*

Yes

No

If "Yes", please describe previous training:

What equipment are you currently using while walking your dog?

Training Required

Please select a program:*

Private Training

Consultation

I am familiar with the tools you are currently using; as well as prong collars, E-Collars, etc., and techniques?*

Yes

No

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Your Information

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Dog Information

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If you answered Yes to Breeder question above.

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Your Dog's Behaviours

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Medical Issues

Previous Training

Training Required

Certified Trainer

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