Name
First Name
Last Name
Pronouns
Address: Brooklyn ONLY for In-Person Sessions
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
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(###)
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Your Email Address
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Partners Name
First Name
Last Name
Pronouns
Other members of the household
Please include relationship and age of any children.
What Training Program are you interested in?
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How did you hear about me?
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Dog's Name
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Sex
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Weight
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Color
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Neutered
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Dog's name at the Rescue/Shelter if different
How long have you had your dog?
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What other pets do you have?
Age, Sex, Spay/Nueter:
Do other dogs in the home have any behavior issues?
Please describe any behavior issues, other dogs yours, your families, or roommates living in the same home, and are they crate trained?
Dog walker and/or Daycare company you use
Vet Clinic
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Current Medications:
Dog Allergies
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If yes, list allergies here
Current or past medical problems or injuries:
Is this dog currently on Heartworm Preventative:
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Is this dog currently on flea / tick preventative
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Describe primary feeding routine
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How often are you feeding, Do you leave the food out, use an Interactive feeder, make your dog wait, in the crate etc...
What are your training expectations
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Your immediate and future goals?
What kind of training has your dog had
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Select all that apply.
If you had training, with who and what did you learn?
Who did you work with, how many sessions and what did you learn?
Is the dog crate trained?
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This means OK in the crate with the door closed and no one home.
Describe issues surrounding crate training
Do you currently use the Crate?
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This means with the door closed.
Does your dog use wee wee pads?
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Allowed to roam free in house when you are not home?
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How long is your dog home alone on average?
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Allowed to run free in yard?
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Allowed on furniture?
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How does your dog react when you leave?
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Have you seen any signs of Separation Anxiety?
Describe walking on a leash:
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How long and many walk per day, how are your walks, good, bad, the more detail the better.
What kind of collar or harness are you using or have used in the past?
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Front/back clip harness, flat collar, martingale, head halter, choke, slip lead, pinch/prong, E-collar.
Do you let your dog meet other dogs on leash?
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If yes, how does it go?
How does your dog react to other animals?
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Cats, birds, squirrels, etc.
Do you currently take your dog to dog parks?
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Does your socialize with other dogs, outside of a dog park?
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At daycare, off-leash hours at parks, "Play Dates" at your or a friends/family home.
If yes , how does your dog do during off leash play and socialization?
How does your dog react when people enter your home?
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Is your dog startled or scared of loud noises?
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Thunderstorms, fireworks, loud trucks, buses, carts, skateboards etc…
If Yes describe:
Is your dog sensitive to any parts of his/her body being touched?
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Ears, mouth, paws, nails, backend, etc
If yes, explain:
Is your dog possessive / growled / snapped / bit over food, toys or other objects?
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If yes, please describe the incident/s
The more information you can give the better.
Has your dog ever growled at someone?
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Human or Dog, other than over an object discussed above.
If yes, please describe the incident/s
The more information you can give the better.
Has your dog ever bitten a human?
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Even snapping and nipping if your dog only left a bruise.
Has your dog ever bitten an animal?
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Even snapping and nipping, and your dog didn't leave a hole or mark.
If yes with a human or animal, please describe the incident/s, as much detail as possible
Please include details of all bite incidents including how approximately long ago they were, did the bite break skin? Were there punctures, did it draw blood or need sutures?
Is your dog Muzzle conditioned?
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If your dog has bit or snapped at someone we will need to Muzzle conditioned your dog.
Does your dog obsessively:
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If so, explain:
Are there any OTHER behaviors or problems you would like addressed?
Jumping, counter surfing, barking at the doorbell etc..
What are your dog's best qualities and what does your dog love to do the most?
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I understand that using a crate may be required for the training program. A crate is a crucial part of the process for dogs with any human aggression, separation anxiety, or fear of new people in the home.
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To help your dog, the training process may require using a crate. Using a crate can help improve behaviors and help attain training goals such as potty training, decreasing separation anxiety, and resource guarding. A crate also gives a fearful or overwhelmed dog a safe place to rest.
It is mandatory for all adults that take care of the dog to be present for the first session, and at all follow up lessons for dogs with behavior issues.
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If all parties cannot attend the first Foundation session or any behavior-related sessions, please reschedule. If Jason shows up without full attendance of the adults, Jason may leave at his discretion. The session will be charged to your program and not refundable. This is for the consistency of training.
I have read the Training Agreement*
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Checking the box “Yes, I agree” is an agreement to these terms.
