Bark To Basics Canine Obedience Center

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Bark To Basics Canine Obedience Center

Certified CPDT-KA trainer, Certified ABCDT trainer

Diabetic Alert Dog Information Form

Information form for a Service Animal…

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Information form for Service Animal

Please fill out the online information form below so that we can better assist you with your specific service dog training needs. All information provided to Bark to Basics Canine Obedience Center LLC (BBCOC) is kept confidential. Once your form is received and reviewed, one of our representatives will contact you.

Name *

First Name

Last Name

Birthdate of potential handler *

Name of Parent/Guardian if handler is under 18

Gender *

Male

Female

Phone Number *

Email Address *

Address *

City *

State *

Zip Code *

What type of service dog are you interested in? *

Diabetic Alert Dog

Psychiatric Service Dog

Are you a military veteran? *

Yes

No

What type of home do you live in? (Apartment, single story home, two story home, etc) *

Handler's Occupation *

Do you or anyone in your home smoke? *

Yes

No

Have you owned or cared for a dog before? *

Yes

No

Are there any other animals that live in your home? If so, please list their breed/type (s), and approximate age (s). *

Please describe what your typical day looks like. *

Do you have questions on payment plans? *

Yes

No

What questions may we answer for you?

When is the best time to call you? *

What concerns do you have about owning a service dog?

Would you like BBCOC to locate and train a dog for you or would you prefer your own dog to be evaluated and potentially trained to be a service animal?

I would prefer BBCOC to locate and train a dog for me.

I would like to have my personal dog evaluated as a potential service animal.

How did you hear about us?

Google

Instagram

Facebook

Other

Thank you!

Home/
Service Dogs/
Obedience Training/
Puppies/
Our videos/
Canine Tidbits/
How To's of Training/
Resources/
MW Grooming/
Service Dog Academy/
- SD Client Portal
- Training Courses
Contact/
About Us/

Bark To Basics Canine Obedience Center

Phone: (602) 803-5845

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