Telephone Consultation Form

To schedule a telephone consultation with Tammie regarding your dog's behavioral issues, please use this form to provide information about your dog and its current management.

Please note that not all behavioral issues can be addressed via telephone.  Puppy management and housebreaking issues are fairly easy to address over the phone.  While, serious aggression issues cannot be assessed without seeing the dog.  Issues between those two extremes may be resolvable during a telephone conversation.  To better understand your current situation, please be as honest and open when answer the questions on this form.

  1. Please provide the following contact information:

    Name
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country
    Work Phone
    Home Phone
    E-mail
    Confirm E-mail

  2. Dog's Name:

  3. Dog's Breed:

  4. Dog's age:

  5. Dog's Gender

    Male - Intact
    Male - Neutered
    Female - Intact
    Female - Spayed

  6. Except for potty / exercise time, how is this dog managed on a daily basis? Select all that apply.

    Mostly indoors, loose in house
     Mostly indoors, confined to room at times (like when we go out)
     Mostly indoors, confined to crate at times (like when we go out)
     Mostly or always outdoors in fenced yard
     Mostly or always outdoors in electronic fence
     Mostly or always outdoors on chain

  7. Besides the above options, how else might you manage your dog?

  8. How does your dog primarily get exercise?

    Runs in fenced yard
     Runs in unfenced yard under supervision
     Runs in unfenced yard without supervision
     Chained outdoors
     Outdoor kennel / run / pen
     Walked on leash

  9. Besides the options above, describe any other methods you use to exercise your dog:

  10. Please choose all of the behavioral issues you are experiencing with your dog:

    Housebreaking
     Jumping Up
     Nipping people
     Biting people
     Aggression towards other dogs
     Aggression towards other animals (cats etc)
     Pulls on the lead
     Barking at people
     Barking at objects or other animals
     Does not come when called
     Runs away
     Overly active indoors

  11. Please list the gender and ages of all adults in the home:

  12. Please list the ages & gender of any children under 17 in the house:

  13. Please list the gender, age and breed of any other dogs in the house:

  14. Please list the number of other significant animals in the house (cats, rabbits, parrots etc.)

  15. Please list the FIRST most important behavioral issue that you are experiencing with your dog (be specific and limit the answer to one issue):

  16. If there is one, please list the SECOND most important behavioral issue that you are experiencing with your dog:

  17. If there is one, please list the THIRD most important behavioral issue that you are experiencing with your dog:

  18. Please enter the email address or telephone number where you would like to be contacted about setting up a telephone consultation (please check your spelling / data entry):

  19. Do you understand that not all training / behavioral issues can be resolved via telephone?

    Yes
    No

  20. Do you understand that, if a telephone consultation is set up, the fee is $1.00/ minute with a 30 minute minimum and 15 minute increments?

    Yes
    No

  21. Please provide any additional information you would like to offer pertaining to the dog's behavioral issues, your management of the dog or the dog's socialization:

  22. Please provide any additional information regarding scheduling the consultation:

DarnFar Ranch
Copyright © 2007 [t. rogers]. All rights reserved.
Revised: 01/08/08