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Jolly Dog Training | Tampa, FL
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Separation Anxiety
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Behavior Consultation Form

First name*

Last name*

Email*

Phone*

Full Address*

Occupation

Preferred method of contact*

Email

Call

Text

Experience*

New Guardian

Experienced Guardian

Preferred location for training sessions:*

In your home

At Jolly Dog Training

Virtual

Dog's Name *

Breed*

Age and Birthday*

Gender*

Male

Female

Spayed/Neutered?*

Spayed

Neutered

Unaltered

How long have you had your dog?*

Where did you get your dog?*

What are your main concerns? Be as detailed as possible*

When did these behaviors start?*

What triggers the behavior?*

What does the behavior look like?*

What happens immediately before the behavior?*

What usually stops the behavior and how long does that take?*

Has your dog ever bitten a person or another animal?*

yes

no

If yes, please describe each incident:*

Who lives in the home?*

Any other animals? *

Describe your dog's daily routine:*

How much exercise does your dog get daily?*

Where does your dog spend most of their time?*

Have you ever worked with another trainer or behaviorist before?*

yes

no

If yes, what methods were used?*

Can your dog be safely handled by you?*

yes

no

Can your dog be safely handled by your vet/groomer?*

yes

no

Do you currently use management tools?*

muzzle

crate

barries (baby gates, x-pens, etc.)

other

none of the above

Any known medical issues?*

Is your dog currently on any medications?*

Has your dog had a recent vet check?*

Are you interested in:

behavior consultation only

behavior board and train

Preferred days/times of training sessions:*

Anything else you would like us to know about your dog or situation?*

I agree to the terms of service

I understand that behavior cases may require long-term training and management, I agree to be honest about my dog's history, including any bite incidents, and I understand that safety if the top priority during training.

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Please upload your dog's vaccination records. Required vaccines include rabies, DHPP, and bordatella.*

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