Forms | EvergreenK9TA

Pre Consultation Form

First Name

Last Name

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Dog's Name

Age

Color

Origin

Veterinarian

Date of Last Visit

If Yes, Please Explain

Upload Updated Rabies/Vaccine Records

Proof of Rabies for all dogs in the home over the age of 3 months old are required prior to scheduling a Consultation and can be emailed to evergreenk9ta@gmail.com. If your puppy has not received Rabies yet please include the date of their scheduled Rabies vaccine in the comments at the bottom.

I understand behavior can be related to health and give permission for ECTA to contact my Veterinarian

Where is your dog kept when left alone?

Crate Trained

House Trained

Dog Friendly

People Friendly

If Yes, Please Explain Bite History

Please explan daily/weekly/regular exercise

Any Previous Training?

Other Members of Household

Other Pets in Household

Why are you contacting ECTA/What issues are you experiencing?

Additional Comments or Information Prior to Entering Home

Thank you for taking the time to complete this form. Your answers will allow me to serve you better. You will be contacted soon.

Pre Consultation Form

Address

Email

Connect