Your Subtitle text

Exam Request

Exam Request Form

Exams are scheduled in one hour increments, on the hour. Please list your top three time preferences. We will do our best to accommodate your preferences, but cannot guarantee that a given slot is available at the time of your request. We will contact you with a confirmation of your exam time. If you need to request a time outside of the regular exam schedule, please give us several dates and times that work for you. We will check availability with our examiners and get back to you.

Name:
Address:
City:
State:
Zip Code:	(5 digits)
Daytime Phone:
Cell Phone:
Email:
Dog's Name:
Dog's Age:
Is dog spayed/neutered?
Is dog current on vaccines or titers? (WA state requires all canines to be current on rabies vaccinations.)
Which Connecting Canines prep course did you take?
Please choose an exam date:
List three exam times on the hour in order of preference (e.g. 1 pm, 2 pm, 3 pm):
I cannot make any of the scheduled times and would like to request an alternate time.
Please list 3 alternate dates and times that will work for you (we cannot guarantee that we can accommodate your request, but we'll try our best):