First Name *

Last Name *

What are your pronouns?

Email Address *

Email Address Again *Make sure you've spelled your email address correctly! Please enter it again.

Phone

City *

State/Province *

ZIP / Postal Code

How did you find us? *

Referrer Name

Your dog's Name *

Your dog's date of birth (if not known, give best guess) *

Date you Acquired Your Dog *

Your dog's breed (if mixed/unknown, give best guess) *

What was your dog's aptitude score (from the video)? *If you have not already watched our video, "Are You Ready to Train Your Service Dog?" you'll need to watch it now to complete this form. Access the video here: https://www.youtube.com/watch?v=u6pUiOf0kdo . Allow at least an hour

Provide additional information on the traits where your dog scored a zero

Please list any classes your dog has already taken or is currently taking and which trainer you worked with:

If you were told that your dog wasn't likely to work out as a public access service dog, what would you likely do? *

Depending on your needs and location, we can train your dog with online classes or lessons (via Zoom), in-home lessons (for those in the Pioneer Valley of Western MA or greater Boston), or do board & train, day school, or private lessons lessons in the Pioneer Valley or North Quabbin area. To guide you toward the most useful options, it helps to know which options work for you.

What is your CURRENT training priority for your dog? *

Other information on handler's disabilities

Our initial replies often end up in clients' spam folder, where they are never seen. We always reply to emails! Please make sure to whitelist us or to check your spam folder.

Agreement *Yes, I will check my spam folder every few days!Yes, I will "whitelist" Sharon@atyourservicedogtraining.com and office@atyourservicedogtraining.com

Other information/questions?

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