Dog Coaching Enquiry Form

The answers provided are confidential, please be honest and accurate in your response.

Please fill in the form for each dog you may have.

Client details

First name:
Surname:
Email address:
Contact telephone day:
Contact telephone evening:
When would you prefer to be contacted:

Coaching Information

Please select a level of priority of the following:

Loose lead walking:		Low Medium High
Off lead:		Low Medium High
Recall:		Low Medium High
Down:		Low Medium High
Sit:		Low Medium High
Stand:		Low Medium High
Changing positions:		Low Medium High
Are you interested in tracking?		Yes No
Is your dog social towards humans?		Yes No
Is your dog social towards other dogs?		Yes No
Behavioural issues:
Rank the severity of the problem:		Mild Moderate Severe

Dog Information

Name:
Breed/Mix:
Age:
Sex:
Status:
What is the purpose of the dog?
Are the following up-to-date:
Vaccinations
Worming Program
Flea Treated
Kennel collar and ID tag		Yes No
How is your dog restrained in your car?
Is your dog fit and healthy?		Yes No
Does your dog have or had in the past any medical conditions?		Yes No
If yes, please describe

Submit your enquiry

Polite Notice

Please note that no training or behavioural advice will be
given over the internet or telephone.