Fill Out For A FREE Phone Consultation Tell us about your dog and have representative contact you about your dog. Date*Please select todays date. Date Format: MM slash DD slash YYYY Name*Phone Number*Email Address*Best time and days to reach youCityPlease list the city you live inStatePlease list the state you live inNumber of DogsOneTwoThreeFourFiveMore than fiveBreed(s)Tell us what breed(s) or mix breed(s) you haveAgeTell us the ages of your dog(s)Sex Male Neutered Female Spayed Male Not Neutered Female Not Spayed Name of your Veterinarian and ClinicVaccination HistoryIs your dog current on all vaccinations? Yes No I don't know Medical ProblemsPlease describe any medical problems your dog has had and/or currently has.MedicationsPlease list any medication your dog has been on in the last year and any current medications along with why your dog was prescribed medication.Prior Dog Training ExperienceHas your dog had prior dog training? If yes, please describe when the training was, with whom, (company name, trainer name), how long the training was, and what the training consisted of.ProblemsHelp us understand your dog. Check all that apply Not Listenig Needs to be taught obedience commands Pulls on the leash Won't stay Distracted Potty training Crate training Marking Destructive/Chewing Steals things Digging Barking Biting Jumping Hyperactive/Too much energy Plays too rough Gets on furniture Gets up on counters Runs out the door Runs off property Aggression towards people Aggression towards strange dogs Aggression with dogs in same house Cat Aggression Fear Aggression Food Aggression Toy Aggression Territorial Aggression Dominance Aggression Generalized Anxiety Separation Anxiety Generalized fear/phobias Thunderstorm Phobias Fireworks Phobias Sound Phobias Visual Phobias Fear of riding in car Fear of Vet visits Fear of grooming Fear of strangers Fear of children Fear of dogs Fear of other animals Other not listed Other Behavior ProblemsPlease describe any problems not listed above.Aggression DetailsIf your dog is aggressive, please describe your dog's aggression in detail.Anxiety/Phobias/Fears DetailsIf your dog has anxiety, phobias, or fears, please describe your dog's anxiety, phobias, or fears in detail.How did you find us?Please select how you found us Google Search Other Search Engine Friend Referred Veterinarian Referred Former Client Referred Advertisement CommentsPlease provide us with any additional comments.