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Your Info

Your name

E-mail

Phone Number

Address

Application Type

Is your dog currently taking any medications or supplements for behavior or mood? If yes, please list names and reasons.

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Welcome to Canine Coverage!

Behavior Buy-In allows pre-existing behavior problems to become eligible for a claim after the 90-day waiting period.

This short form gives us the information needed to determine whether Behavior Buy-In is the right option for you and your dog.

It only takes a few minutes to complete.

Behavior Buy-In Application

Your Info

Today's Date * required

Your name

E-mail

Phone Number

Address

Dog's Info

Dog's name

Age

Breed

Sex

Add a photo of your dog

Behavior Overview

Does your dog have any current behavior problems? *

Yes, a minor issue

Yes, a major issue

Has your dog ever bitten, or attempted to bite, another person or dog? *

Yes

Which best describes their behavior problems, if any? * Required

Human aggression

Dog aggression

Reactivity

Fearful/shutdown

Anxiety

Destructive behavior

Other

If "Other", please explain:

Please describe, in detail, your dog's behavior issues (if applicable):

Has your dog ever worked with a trainer before?

Is there anything else you'd like us to know?

Upload Evidence

Put photo or video evidence of the behavior problem here.

Upload Files

Review & Confirm

Before we build your profile, please confirm the following:

I understand that coverage only begins after I activate my membership and complete the waiting period.

I understand that Canine Coverage provides access to behavior support and training through approved Behavior Claims and is not an emergency veterinary or crisis response service.

I understand that any current behavior concerns disclosed in this form are considered "pre-existing" and are not eligible for coverage.

I certify that the information I provided is accurate to the best of my knowledge.