Behaviour Modification Registration Form

Please complete this form and we will be in touch with you very shortly with a referral to a trusted colleague or a recommendation. If you have been referred to us by your Veterinarian, please note that in this form. 

Your full name *
Your full name
Phone *
Phone
(555-555-5555)
Dog's date of birth *
Dog's date of birth
If unknown, please estimate
What behaviour concerns prompted you to contact us today? *
Please check all that apply
Are you open to starting with Virtual Consultations for now? *
Sometimes we come across challenges that can be addressed through a virtual consult, whether it's to brainstorm some creative solutions together or to hold you over until an appointment can be made to see a trainer. Virtual consultations generally take place via video-conferencing software (Zoom) but can happen via telephone if you prefer. There is quite a lot that we can do virtually!