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Your Information

Name*

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Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Pet Information

Pet Name*

First

Breed*

Date of Birth*

Age*

Weight*

Gender*

Spayed / Neutered*

Does your dog have any medical issues?*

Is your dog currently on any medication? If so, please list all medications.

Please list any medical information that may be relevant to us.

Does your dog have any medical/physical restrictions?*

Please describe any restrictions your dog may have.

Shots Up To Date*

Is your pet up-to-date on their shots?

Bite History*

Does your dog have a bite history?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

Is Your Dog Crate Trained?*

Yes

Is your dog comfortable in the crate? Please explain.*

How Many Dogs Are In The Home?*

2nd Pet Name*

First

Breed*

Date of Birth*

Age*

Weight*

Gender*

Spayed / Neutered*

Does your dog have any medical issues?*

Please list any medical information that may be relevant to us.

Does your dog have any medical/physical restrictions?*

Please describe any restrictions your dog may have.

Shots Up To Date*

Is your pet up-to-date on their shots?

Bite History*

Does your dog have a bite history?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

Is Your Dog Crate Trained?*

Yes

Is your dog comfortable in the crate? Please explain.*

3rd Pet Name*

First

Breed*

Date of Birth*

Age*

Weight*

Gender*

Spayed / Neutered*

Does your dog have any medical issues?*

Please list any medical information that may be relevant to us.

Does your dog have any medical/physical restrictions?*

Please describe any restrictions your dog may have.

Shots Up To Date*

Is your pet up-to-date on their shots?

Bite History*

Does your dog have a bite history?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

Is Your Dog Crate Trained?*

Yes

Is your dog comfortable in the crate? Please explain.*

4th Pet Name*

First

Breed*

Date of Birth*

Age*

Weight*

Gender*

Spayed / Neutered*

Does your dog have any medical issues?*

Please list any medical information that may be relevant to us.

Does your dog have any medical/physical restrictions?*

Please describe any restrictions your dog may have.

Shots Up To Date*

Is your pet up-to-date on their shots?

Bite History*

Does your dog have a bite history?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

Describe The Bite Itself.*

Was skin broken? Was medical attention required?

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

How Did The Bite Occur?*

Describe all bites separately and please provide dates and location for each.

Is Your Dog Crate Trained?*

Yes

Is your dog comfortable in the crate? Please explain.*

Interested In*

Private Training

Puppy Enrichment Program (Puppies 4 Months and Under)

Behavior Optimization Retreat

Video Calls

How Did You Hear About Us?*

Who referred you/Referral code?*

Which media post did you watch?*

Which ad did you see?*

OTHER

Additional Information*

Describe the behavioral issues you are having with your dog(s). Please be specific as this will be highly useful for us to assess your situation before speaking to you personally. If you are interested in one of our dog walking programs, describe your dog's behavior on leash and any issues with leash walking we should know about.

Disclaimer*

I am familiar with Pack Leader Dog's training methods, techniques and programs. If not, please be sure to check out our Services and FAQ pages. By agreeing below, I certify all information is true and correct to the best of my knowledge.

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Our Location

Contact Details

Location: Northern, New Jersey

Email: info@packleaderdogs.com

Phone: (201) 528-3647

More Info

Steve Del Savio, Founder & CEO of Pack Leader Dog Care Services, is a Dog Psychology & Behavior Expert and Assistant Trainer of Cesar Millan “the Dog Whisperer.” He and his team have worked with thousands of dogs and people by rehabilitating dogs and educating people in Dog Psychology.