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Clever Creatures
Introduction form.
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Email
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Your email
What service are you interested in?
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Private sessions
Online group class
Puppies at the vet
Other:
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Your Name (First and last)
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Your answer
Address, city, state
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Your answer
Phone number
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Your answer
Pet name(s)
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Your answer
Pet(s) breed (if mixed breed, provide your best guess as to what they are a mix of)
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Your answer
Pet(s) age (~or rough estimate)
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Your answer
Pet(s) sex? Are they spayed/neutered? (example: Female, spayed)
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Your answer
When did your pet arrive in your home and from where (breeder/rescue?)
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Your answer
When was your pets last veterinary exam and what is the name of there veterinary clinic?
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Your answer
Is your pet on medications, supplements, or preventatives? (please list all)
Your answer
Does your pet have any medical / health concerns?
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Your answer
Is your pet up to date on their core vaccinations?
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Yes
No
Other:
What are their favorite activities?
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Your answer
Describe the behavior concern(s) in detail. If multiple pets, put the pets name after the behavior concern (example: Jumping on people - Fluffy, biting-Sam)
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Your answer
If multiple behavior concerns, list the behavior concerns starting with the behavior of greatest concern (most concerning behavior to least concerning behavior)
Your answer
Do you perceive the behavior concern(s) as urgent?
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Not very
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URGENT
Do you have safety concerns for yourself, your pet, or others interacting with your pet? Please describe.
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Your answer
How long has the behavior concern been happening?
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Your answer
Are there other pets in the house? Name / age / sex/ breed ?
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Your answer
Has your pet attempted to or successfully bitten before? If yes, describe the bite incident.
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Your answer
Does your pet have access to a securely fenced in backyard?
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Yes
No
What equipment do you use for your pet? (example: leash, collar, prong, muzzle, shock, gentle leader, harness, ect)
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Your answer
Session format: I am interested in...
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virtual sessions, to be conducted over zoom
in-person sessions (A travel fee may apply)
Other:
For private sessions (virtual or in-person): To be billed at an hourly rate of $150/hr, in 15 minute increments. Sessions on average are 1 hour duration.
I understand!
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How did you hear about Clever Creatures?
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Google or other search engine
From a friend
From my Vet
From another animal professional
Other:
I look forward to working with you!
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I'm ready to get started!
I'm still thinking about scheduling and will contact you when I am ready
Other:
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