Trainer to Trainer Consulting Services Registration This form is best completed on a computer, not a mobile device. Trainer to Trainer Consulting Services Contract Trainer & Dog Client Information Your Company or Organization * Company name Trainer's First Name * First Trainer's Last Name * Last Chosen pronouns (if you'd like to share) How did you hear about me and this service? * Please list your professional credentials and education. * Email Address * Cell Phone * Client's Dog's Name * Weight/Breed/Age/Sex * Spayed/Neutered * Yes No Amount of time in current home * Household Information (please list all humans who live in the home - include ages of minors) * Household Information (please list any other non-human animals who live in the home include species, age, sex and spay/neuter status.) Enter N/A if none. * Important Medical History Notes & Medications (N/A if none) * What are the issues the client initially came to you with? * What training have you done to try to resolve the issue? What has worked/what progress has been made? * What struggles are you still having that you would like assistance with? * Did this client use a trainer prior to you? Are you aware if any aversives (including but not limited to dominance, corrections, alpha rolls, prong, choke or shock collar) have been used at any point with this dog? * Upload Case Files for Review including any training plans, client notes, homework, handouts, intake form, and vet or client communications Drop a file here or click to upload Choose File Maximum file size: 52.43MB Additional Files for Upload Drop a file here or click to upload Choose File Maximum file size: 52.43MB Do you need any disability-related accommodations to fully participate in this consultation or future training? For example, closed captioning for Zoom? Please feel free to share any information you are comfortable sharing. Anything else we missed you'd like to share? Submit If you are human, leave this field blank.
