Jeff Stallings, CPDT-KA Client Intake and Release

Please complete the following form with as much information as possible about you and your dog.  (Some of this information may not be available or pertinent for newly adopted dogs or puppies, so leave these fields blank.)

A copy of this information will be emailed to you and to me after submission.  I do not share this information with anyone else or other entities without your explicit consent.

Before submitting, please read through and click to accept the Liability Release at the end of the form; this is standard release language for professionals working with dogs.