JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Private Training Initial Contact Form
Initial contact form for individuals inquiring about E-Learning or In-Home Training
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name - Primary Dog Owner
*
Your answer
Last Name - Primary Dog Owner
*
Your answer
Primary Dog Owner Home Address (not P.O. Box)
*
Your answer
Email Address
*
Your answer
City
*
Your answer
State
*
Your answer
Home Phone # (include area code)
*
Your answer
Mobile Phone # (include area code)
*
Your answer
Name of Dog
*
Your answer
Gender of Dog
*
Female intact
Female spayed
Male intact
Male neutered
Age of Dog
*
Your answer
Breed(s) of Dog
*
Your answer
How long has dog been in your home?
*
Your answer
Where was dog acquired?
*
Professional Breeder
Humane Society / SPCA
Rescue Organization
Private Party
Other:
What behavior do you want to correct?
*
Puppy Socialization (Puppies 7wks to 20 weeks of age)
Basic Manners - Jumping up, pulling on leash, come when called, stay, leave it, sit/down, etc.
Barking, growling, lunging at or biting strange people or other dogs
Fearful or Anxious behavior (hiding, panting, pacing, avoidance, shaking, barking, etc.)
Veterinary visit or grooming handling problems (doesn't like to be touched/handled)
Therapy Dog Prep Training
Other:
Required
What previous training has your dog had?
*
Formal puppy socialization training (in group class or with a certified trainer)
Group class manners training
Private manners training with a certified trainer
None
Other:
Required
Have you experienced complaints from neighbors, landlords, police or animal control about your dog's behavior?
*
Yes
No
What type of training delivery are you most interested in?
*
e-Learning (convenient trainer coaching via phone, internet, camera and/or video)
In-Home Training (when local, trainer comes to your house or other location to train your dog)
Either option (trainer can direct me based on my learning goals to best method)
How did you hear about us?
*
Veterinarian
Google / Internet Search
Pet Store or Local Pet Related Business
Pet Related Local Event
Other:
Brief Questions?
Your answer
Next Steps - Once we receive your completed form, we will contact you by phone or email to set up a brief appointment to chat about your behavior goals and problems. Preferred contact method?
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of A Good Dog Day Behavior & Training.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report