Moira Hechenleitner DVM, CSAT
Email: moira@separationanxietydog.com
Helping families through remote support
anywhere in the world in English or Spanish
First Name
Last Name
Pronouns (optional) Email Are you a dog guardian or a dog pro? —Please choose an option—GuardianPro
Your Message
Phone number*
Location (City, State, Country)*
Dog's name*
Dog's age*
Dog's gender* MaleFemale
Where did your dog come from?* ShelterBreederOther
Breed or mix type*
How long has the dog been in your home?* —Please choose an option—Less than 3 weeksLess than 1 monthLess than 3 months3 - 6 months6 - 11 months1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years or more
How long does your dog currently stay alone each time?* —Please choose an option—NeverLess than 1 hour1 - 2 hours2 - 4 hours4 - 6 hours6 - 8 hoursMore than 8 hours
Additional comments about your dog's current time alone, can be entered here:
Have you done any Separation Anxiety related training with your dog in the past?*YesNo
Please provide more detail:
Have you discussed your dog's Separation Anxiety with your veterinarian?*YesNo
How long would you like to be able to leave your dog alone in the future?* —Please choose an option—Less than 1 hour1 - 2 hours2 - 4 hours4 - 6 hours6 - 8 hoursMore than 8 hours
Additional information regarding the last question, can be provided here:
Please let me know how you heard about me* Colleague/Friend/RelativeOnline searchSocial MediaDog trainer/VeterinarianOther
If appropriate, please enter the name of the referral:
Thank you for completing the contact form. I'll contact you as soon as possible!
