Let’s work together. Dog's Age * First Name Last Name Email * Phone (###) ### #### Dog's Name * Dog's Age * Breed Sex and Altered Status * Check Male or Female and if they're fixed or not Male Unaltered Male Neutered Female Unaltered Female Spayed Problem behaviors * Check all that apply Aggression (toward people) Aggression (toward other dogs) Reactivity/Lunging on leash Fear/Anxiety Separation anxiety Excessive barking Destructive chewing Jumping Guarding Other Behavior Details * Describe the behavior in detail, including where/when it occurs Onset and context * When did this behavior start? Under what circumstances does it happen (location, time of day, who is present)? Interventions tried Bite/aggression history Has your dog ever growled at, snapped at, or bitten a person or another animal? Yes No Household * List any children (with ages) or other pets at home and how the dog interacts with them Goals * What is your ultimate goal? Terms of Service * By checking this box, you acknowledge that you have read and agree to the Terms of Service Thank you for submitting your intake form. We’ll be in contact with you within 24 hours to schedule your consultation and next steps. For our Terms of Service, please visit https://www.southeastk9s.com/terms-of-service. Terms of Service
