First & Last Name
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First Name
Last Name
Phone
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(###)
###
####
Email
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Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Best way to contact?
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Emergency Contact #1
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First Name
Last Name
Emergency Contact #1 Phone Number
*
(###)
###
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How did you hear about us?
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Dogs Name
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How did you get your dog?
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Dogs Birthday (if known)
MM
DD
YYYY
Dogs Age
Dog Breed or Mix
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Dogs Sex
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Has your dog been Spayed/Neutered?
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Date of Spay or Neuter
MM
DD
YYYY
Is your dog Up To Date on all Vaccines? Including Rabies
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Please email or text a copy of all vaccination records
Vaccination Record Available
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You will be required to email or text over vaccination records before any training classes begin.
Date of Last Rabies Vaccination
*
MM
DD
YYYY
Date of Last DHPP/DHLPP
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MM
DD
YYYY
Date of Last Flea/Tick Preventative
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MM
DD
YYYY
Veterinarian Name
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Veterinarian Phone Number
*
(###)
###
####
Veterinarians Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Please list any past or current health conditions
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Does your dog take any medication? If yes, please list medication(s), dose, and time medication is administered.
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What food is your dog currently eating?
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Amount of food AM? PM?
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Favorite Treats
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Is your dog allergic to anything?
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Has your dog ever displayed any form of aggressive behavior? If so, please describe the situation(s) surrounding the incident(s). Please include any history of bites or attempted bites on humans or dogs. If this has never been an issue, please write "none."
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Does your dog seem fearful or anxious in any situations or environments? Please include what the reaction may look like and how you handle these situations.
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Please describe any other behavioral issues/concerns you have experienced with your dog, including what you have noticed triggers the behavior. If none, write "none."
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What does your dog like? What makes him/her happy?
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How many walks does your dog typically get each day? Duration/distance?
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How much exercise does your dog get per day?
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How much ACTIVE exercise does your dog get a day?
Example: Running, Playing Fetch, Swimming, etc. (not leisure walks)
** Please only pick one option. Honesty is import**
Does your dog participate in any sports or activities? If so, please elaborate.
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Has your dog received any prior training? If so, please elaborate - where did they go for training and when? What did they learn? What methods or tools were used? The more information you can share, the better!
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Is your dog housebroken?
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Is your dog crate trained and comfortable being crated?
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Who resides in your home? Please check all that apply.
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Please describe how your dog behaves around other dogs. Please include how your dog behaves when seeing another dog on leash.
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Please describe how your dog behaves around children. Please include how your dog behaves when seeing children running or screaming. If your dog has not had any experience with children, please write "not sure."
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Where do they spend time during the day?
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Where does your dog sleep at night?
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Is there anything else you feel is important for us to know?
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Do you have any specific training goals for your dog?
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Which type of program interests you? Please check all that apply.
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How soon are you looking to begin training?
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Availability
*
Please check all time slots that you are available
Todays Date
*
MM
DD
YYYY
