5-Week Separation Anxiety Package

*First name

*Last name

Multi-line address

*Country/Region

*Address

*City

*Zip / Postal code

*Email

*Phone

Must include 1 and area code

*Dog's Name

*Dog's Age

*Dog's Breed

*Where did you get your dog from?

*How long have you had your dog?

*Is your dog Male or Female?

Male

Female

*Please list other members of the household. If there are children in the home please indicate their ages.

*Please list other pets in the home.

*Please list out the daily exercise and enrichment your dog gets.

*How long is your dog being left alone at the moment?

*Have you spoken to your vet about your dog’s separation anxiety?

Yes

If yes, what was the outcome of your conversation with your vet?

*For separation anxiety training to work, you really would need to find a way to stop leaving your dog. How do you feel about that?

That's unrealistic

Might be doable

I'm already doing that, my dog is never left alone

Other

*What other training have you done to address your dog’s separation anxiety? Please outline below. *

Please give me any more background about your dog that you think might be helpful.

*How did you hear about me?

Friend/Colleague/Relative

Online search

Facebook

Dog trainer

Vet

Please provide the name of the business or person who referred you.

I would love to have a photo of your dog!

*I agree to allow the photo submitted to be used on the business social media pages of Khris Erickson, LLC. The purpose of these postings would be to highlight the success of the training.

Yes

No identifying client information other than the name of the dog would be posted.

Mail

Khris Erickson Dog Training

Khris Erickson, LLC

Specializing in Canine Separation Anxiety

Serving separation anxiety clients between the Greater Milwaukee Area and Madison, as well as throughout the USA

Serving in-person clients within 20 miles from Ixonia, WI

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