Tell us
about you and your dog

This helps us prepare for your consult. Answer what you can, and use your best guess where you're unsure.

1 · Handler's Information

First name *Last name *

Phone number *Email address *

Preferred method of communication *

EmailPhone callText message

Street address *Unit number

Are there other humans living in the home?

YesNo

If yes, please indicate first name and age.

Are there other animals living in the home?

YesNo

If yes, please indicate species and age.

2 · Dog's Information

Dog's name *Dog's date of birth or ageBest approximation of age if unsure.

Dog's breedBest guess if unsure.How old was your dog when you adopted?

Where did you adopt your dog from?

Dog's veterinary clinic

Clinic nameClinic phone

Clinic address

Does your dog have any medical conditions?Please list conditions and whether they are on medication.Does your dog have any allergies?List each allergy (food, environmental) and any medication used.What brand of food does your dog eat?What kind of treats does your dog enjoy?Please list ALL that apply.

Does your dog have a history of aggression?

YesNo

If yes, please include dog–dog, dog–human, dog–object aggression, and food guarding.

Does your dog have a bite history?

YesNo

If yes, please describe.

Are your dog's vaccination records up to date?

YesNo

How your information is handled

What & why: Your contact details, address, and your dog's health and behaviour history are used only to contact you, plan training, and keep people and dogs safe during sessions.
Who sees it: Only the trainer at Daisy Duke Dog Training. It is never sold or shared for marketing.
Where it's stored: Submissions are received through our website host, Netlify, whose servers are in the United States, so your information may be subject to U.S. law.
How long: Kept while you're a client and deleted within 2 years of your last session, or sooner if you ask.
Your rights: You can ask to see, correct, or delete your information at any time by emailing info@daisydukedogtraining.ca.

3 · Scheduling a Consult Appointment

What training program are you interested in?Please select all that apply.

Puppy TrainingBasic MannersLoose Leash WalkingOther:

Day	11AM–3PM	3PM–6PM	6PM–9PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Tell usabout you and your dog

Tell us
about you and your dog