Name*
First Last
Phone Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Date you would like to drop your dog off*

We are open for drop off or pick up Monday - Friday, 9am-5pm, Saturday 8am-9am and 2pm-5pm. If you need to drop off or pick up outside of these hours or on Public Holidays then there is an additional $50 surcharge per pick up or drop off.
Do you need to drop your dog off or pick up outside of hours?*
- Yes drop off + $50
- Yes pick up + $50
- No I will not need to drop my dog off outside of hours.
Time you will be dropping your dog off*

: HH

MM
Date you would like to pick your dog up*

Note we do not do drop offs or pick ups on Sundays
Time you will be picking your dog up*

: HH

MM
Emergency contact person
Preferably someone who is going to be available in this country if you will not.
Name
First Last
Email
Phone Number
Is this person authorised to pick up your dog?*
- Yes
- No

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Whilst your dog is staying with us, what behaviours would you like us to work with?

Whilst we would like to work on every problem, the more problems we work with means the time on each problem is less.
Priority 1 behaviour to work on is*
Please list any secondary behaviours you would like us to work on.
What do you hope to gain by leaving your dog with us for Board and Rehab?*
Name
This field is for validation purposes and should be left unchanged.

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Steve Courtney Dog Trainer Dog Trainer & Behaviorist Australia

FORM – Board, Rehab, Training with Steve Courtney and K9Pro