Boutique

Customer*

First name Last name

Other people living at the same address :

Spouse
Child
Mother / Father
Brother / Sister
Friend
Other

Spouse

First name	Last name

First names of other people living at the same address :

Customer informations

Address*

Address 1 Address 2 City Province Postal code

Email*

Phone

Portable
Home

Give the phone number*

Phone 2

Home
Office
Spouse's cell

Give the phone number

Referred by?*

Veterinarian
Pet Shop
Friend
Neighbour
RQIEC
Facebook
Other

Specify

Desired services?*

Specify

Date of chosen Kindergarten class

Enter STARTING DATE for chosen class. Dates for coming Kindergarten classes are found on « Group training » page

Date of chosen Obedience group training – Level 1 class

Enter STARTING DATE for chosen class. Dates for coming Obedience group training – Level 1 classes are found on « Group training » page

Date of appointment / first session

Fill out only if you’ve already set a date with us

How many dogs do you have?*

Dog 1 *

DOG's name*

Breed*

Date of birth*

Gender*

Neutered?*

Dog 2

DOG's name

Breed

Date of birth

Gender

Neutered?

Dog 3

DOG's name

Breed

Date of birth

Gender

Neutered?

Do you have any pets, other than dog?*

Yes
No

Specify

Describe the observed behaviors and your goals :*

By clicking this box, I recognize having read and accepted the "Terms & Conditions"

http://unhommeetdeschiens.com\/en/terms-conditions/

CAPTCHA

Aide à l’adoption d’un chien

Consultation comportementale

Cours privé débutant

Évaluation pour assurance

Forfait comportemental – Cas difficile

Forfait comportemental – Cas léger

Jouet interactif Kibble-Nibble – Moyen/Grand

Jouet interactif Tug-a-Jug – Moyen/Grand

Jouet interactif Tug-a-Jug – Petit

L’ABC canin en vidéo

Laisse d’entrainement en cuir noir ½’’ x 72’’

Laisse d’entrainement en cuir noir 1’’ x 72’’

Services

NOUS JOINDRE

RÉGIONS DÉSSERVIES

Customer informations