Emma Kesler CPDT-KA Client Form
Email address *
Your Full Name *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Address: Street *
Your answer
Address: City *
Your answer
Address: State / Province *
Your answer
Address: ZIP / Postal Code *
Your answer
Address: Country *
Your answer
Family Members *
It is helpful if you describe each member's relation (husband/wife, teenage child, young child)
Your answer
Do you use an iPad or iPhone? *
(It is ok if you do not)
Dog's Name *
Your answer
Dog's Breed *
Your answer
Dog's Date of Birth *
Your answer
How old was your dog when you got him/her? If you haven't gotten him/her yet, please just provide any relevant information about when you might be bringing the dog home and how old they will be. *
Your answer
Please tell me about previous dogs you or your family have owned. *
Your answer
Please check all that apply (SKIP if you don't have the puppy or dog yet):
What type of food does your dog eat (Or what are you planning on feeding your new dog?) *
Would you ever feed your dog raw food? Please answer honestly. *
Do you have a yard? What kind of containment system do or will you use? *
How often is your ADULT DOG left alone, or how often will your PUPPY be left alone? Please describe the circumstances/routine. *If you are bringing a new dog/puppy home, PLEASE double-check the availability of friends/family before answering this, and give me a detailed idea of the plan over time. *
Your answer
Do you have preferred day(s) of the week, and/or time(s) of day for training sessions? *
Your answer
How motivated are you to learn a new way of training? *
Not Very Motivated
Very motivated
Describe your training concerns and/or goals, any training history of note, and please explain why you feel you would be a good candidate for training with Emma Kesler CDPT-KA: *
Your answer
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