Cooperative Care, dogs 4 months and older

First and Last name *

Email *

Address *

City *

State *

Zipcode *

Phone *

Dog Name *

Age *

Breed *

Is your dog current on their distemper/parvo vaccine? * Yes
No

Is your dog current on their bordetella (kennel cough) vaccine? * Yes
No

Is your dog current on their rabies vaccine (required for dogs 4 months and older)? * Yes
No

Is your dog current including both rounds of their canine influenza vaccine? (recommended but not required) * Yes
No

What does your dog do in the presence of other dogs that are 10 feet or so away? *

On the first day of class, how old will your dog be? *

Comment

I have read and understand the above disclosure. *

Please enter your initials: *

Do you have a gift certificate or coupon?
*You are required to bring your gift certificate or coupon on the first day of class in order to receive the discount. If you do not bring proof of the discount, you will be charged the full amount. Please note you cannot use multiple coupons or discounts for behavior classes. * yes
no

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