Prospective Client Separation Anxiety Questionnaire - Cold Nose College

Prospective Client Questionnaire

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If your dog is suffering from separation anxiety and you’d like to consider training with us, please complete the following questionnaire. Filling out this questionnaire does not guarantee that we will be able to accept you as a client. We look forward to assessing your case and seeing if we can assist you! Thank you.
Client(s) Name*
Email*
Enter Email Confirm Email
Phone
Location (City, State)
Dog's Name
Age and Gender of Dog
Where dog was acquired? (Shelter/Breeder/Other)
Breed Type or Mix Type
How long has dog been in your household?
How often is your dog currently being left alone?
Can you adjust your schedule so that during training your dog will not have to be left alone for a while?
Have you done any previous training to address your dogs separation anxiety? (explain as needed)
How long would you like to be able to leave your dog alone in the future (specify in hour range such as 2-4)
Please let us know how you heard of us.
Please click on Submit when you have finished with the form. We appreciate your time and will get back to you as soon as we can! (Hang in there!!!)
Email
This field is for validation purposes and should be left unchanged.

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