Contact Information Form
For use by Barker Canine Academy only
First and Last Name
Best way to contact you (Mark all that apply)
When is the best time to contact you?
What times are you available for training?
What areas are you interested in improving with your dog? Please mark all that apply.
Puppy Obedience Training
Basic Adult Obedience Training
Advanced Adult Obedience Training
CGC (Canine Good Citizen) training
Anxiety/Fear (storm, vet visits, etc)
My pet is:
Does your pet have any food allergies? If yes, please state what they are allergic to.
Date of Rabies Vaccine.
Is the Rabies vaccine a 1 year or 3 year vaccine?
Date of Dhpp Vaccine.
Is the Dhpp vaccine a 1 year or 3 year vaccine?
Do you give me permission to contact your Veterinary Clinic to verify vaccines? If you do not know the dates of vaccines this will give permission to get that from your Veterinarian.
If yes, What is the name of your Veterinary Clinic and their phone numer?
How did you hear about Barker Canine Academy?
Would you allow us to use pictures/videos of your pet on our website and social network sites?
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