Monthly Follow-UpAssistance Canine Training ServicesPO Box 52North Conway, NH 03860(603)383-2073info@assistancecanine.org The completion of this form is in keeping with your agreement to the follow-up policy of A.C.T.S. Please answer the following questions. Date MM DD YYYY Contact Information Client Name * First Name Last Name Dog Name * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Follow-Up Questions Please Choose One * We are doing well and have no issue. There is no reason to contact me at this time. I have some questions. Please contact me. If you would like us to contact you, please provide us with an ideal time to call you. I continue to provide routine veterinary care including a yearly wellness exam and vaccinations. * Yes No If you selected "No," please explain. I continue to provide adequate nutrition through proper diet and clean water at all times. * Yes No If you selected "No," please explain. Is your dog their proper weight? * Yes No If your dog is not their proper weight, please explain. I continue to provide daily exercise and regular bathing and grooming. * Yes No If you selected "No," please explain. Use the space below to provide us with any other information you would like to tell us. I acknowledge that by entering my name below and submitting this application, that all the above information is accurate. Name * First Name Last Name When you click the SUBMIT button, the final version of this form will be sent to A.C.T.S. Thank you!
