Emma Kesler CPDT-KA Client Form
Thank you for your interest!

* This form is to be considered for training with Emma Kesler CPDT-KA for private training or behavioral consultation.

* All other inquiries please email me at emma.kesler@gmail.com. Do not fill out this form if you are not interested in training.

* Please be advised that these training programs are not compatible with invisible fences, e-collars, and prong collars. If you currently use or plan on using one or more of these but are open to a different approach and have questions, feel free to email me at emma.kesler@gmail.com prior to filling out this form.
Email address *
Today's Date *
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Your Full Name *
Your answer
Phone Number *
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
What time zone are you in? (Example: CST, PST) *
Your answer
Family Members *
It is helpful if you describe each member's relation and children's ages (husband/wife, teenage child, young child)
Your answer
Current other pets
Please list and describe your other current pets
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 *
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Dog's Current Age *
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
Did you grow up with dogs? If yes, tell me about them. Breed, temperament, etc. *
Your answer
Have you owned dogs as an adult? If yes, please tell me about them. Breed, temperament, etc. *
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? *
Do you have a yard? If so, what kind of containment system do or will you use? *
Please note: I do not think it is a bad thing if you don't have a yard, and that I am respectfully declining prospective clients who plan to use invisible fences or tie-up systems.
How often is or will your pupp/dog be left alone at home? PLEASE read through the following options and be as accurate as possible. *
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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