Courteous Canine, Inc.

We provide dog training, behavior consulting, dog sport, daycare plus and in home boarding and board and train services. Our staff are certified or working under the supervision of certified trainer.

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Name*

Email*

Phone*

Address*

How did you hear about us?*Drive ByFacebookOther Social MediaGoogleOther Search EngineFamily/Friend/NeighborGroomerNewsletterRescue GroupOther Courteous Canine Inc. ClientsRescue GroupVeterinarianOther

Location Preference for Behavior Consultation:*On Campus ($150 for the first 90 min appointment) - 3414 Melissa Country Way, Lutz, FL 33559In your home ($180 for the first 90 min appointment - $20 Travel fee may apply)Virtually by Video call ($150 for the first 90 min appointment) No Preference

Preferred time of day and day of week for your training session, please check all that apply:*During the day during the weekDuring the evening during the weekOn the weekend

Pet Name*

Birthday*

Breed*

Weight*

Sex*

Spayed or Neutered *YesNoUnknown

Is your dog microchipped?*YesNoUnknown

What is the main behavior problem or complaint?*Dog AggressionHuman AggressionKid AggressionOther

If Other, please describe:

Is this dog or any other dogs fighting with each other in your home? *YesNo

If your dog has bitten a person please describe the severity of the bite?*

If your dog has bitten a dog please describe the severity of the bite?*

What are the top 3 goals you are looking to accomplish?*

By selecting the field below I agree to provide up to date shot records for my dog prior to my first appointment by emailing shot records to [email protected]*

Current - CCinc Waiver Sep 2025.docx

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