Emma Kesler, CDBC, CPDT-KA Client Form
Thank you for your interest! This form is to be considered for dog behavior consulting or coaching with Emma Kesler, CDBC, CPDT-KA.

Please review the following:

1) This page: https://milesandemma.com/training

2) If approved, it can take 4+ weeks to get into the schedule. If you are getting a puppy, the first meeting is ideally conducted before your pup comes home, so please apply in advance if you can!

3) These programs are not compatible with invisible fences. If you currently use an invisible fence and are open to alternatives, I welcome you! If you are not willing to consider an alternative, I respectfully decline.

4) If you don't hear from me after 48 hours, please email me: emma.kesler@gmail.com (please fill out this form before emailing me).
Email *
Today's Date *
Your Full Name *
Phone Number *
Address: Street *
Address: City *
Address: State / Province *
Address: ZIP / Postal Code *
Address: Country *
What time zone are you in? (Example: CST, PST) *
Family Members *
It is helpful if you describe each member's relation and children's ages (husband/wife, teenage child, young child)
If you live with a partner or spouse, please provide their name and email address (please do not put your own email address!)
Current other pets
Please list and describe your other current pets. Age, species, breed. Please be detailed in your answer.
Do you use an iPad or iPhone? *
(It is ok if you do not)
Dog's Name *
Dog's Breed *
Dog's Date of Birth *
Dog's Current Age *
How old was your dog when you got him/her? Provide any other details you are aware of about your dog's life prior to coming home with you. If you haven't gotten your dog yet, please just provide any relevant information about when you might be bringing the dog home, how old they will be, etc. *
Please specify where your dog came from, or will come from (rescue/shelter, private party, breeder) and provide details. *
Did you grow up with dogs? If yes, tell me about them. Breed, temperament, etc. *
Have you owned dogs as an adult? If yes, please tell me about them. Breed, temperament, etc. *
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?) *
Do you have a yard? *
Please note: It is perfectly ok if you don't have a yard!
How often is or will your puppy/dog be left alone at home? PLEASE read through the following options and be as accurate as possible. *
Do you have preferred time of day for sessions? *
How did you hear about this service? Did someone refer you? *
Please describe any previous training history and/or methods: *
How motivated are you to learn a new way of training? *
Not Very Motivated
Very motivated
Which service/program(s) are you inquiring about? *
Please summarize your concerns and/or goals, any previous training or history of note, and explain why you feel you would be a good candidate to work with Emma Kesler, CDBC, CDPT-KA. Spots are limited, please be detailed: *
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