Application for Training:

Please fill out the form below:
By filling out this form I will be able to better understand any behavior issues and your training needs.

Name *

Name

First Name

Last Name

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Phone

(###)

###

####

Email Address *

Other Members of Household:

Please include relationship and age of any children.

How did you hear about me? *

Note/Message

What time of the day is best for you?

My initial visit is a “Train at Home" session which is $125, includes the evaluation and last around 2 hours. It is best for all members of the household to be home.

About Your Dog

Dog's Name *

Sex *

Male

Female

Dog's Breed/Mix *

If you don't know the mix you best guess is fine.

Age *

Approximate age for rescue dogs is fine.

Weight *

Color *

Neutered *

Yes

Not Yet

Where was the dog obtained? *

Shelter/Rescue or Breeder info

Age when your dog was obtained: *

How long have you had your dog.

Other Household Pets

Age, Sex, Spay/Nueter:

Medical

Vet Clinic *

Current Medications:

Dog Allergies *

Yes

If yes, list allergies here

Current or past medical problems or injuries:

Is this dog currently on Heartworm Preventative: *

Yes

Is this dog currently on flea / tick preventative *

Yes

Not during the Winter

Food

What type of food are you feeding your dog? *

What kind of food, and how much?

Describe primary feeding routine

How often are you feeding, Do you leave the food out, use an Interactive feeder, make your dog wait, in the crate etc...

Training

What are your training expectations *

Your immediate and future goals?

What kind of training has your dog had *

Select all that apply.

Private Training

Group Puppy Class

Group Class for Obedience (OTHER than a puppy class)

No Professional Training

Other

If you had training, with who and what did you learn?

Is the dog crate trained? *

This means OK in the crate with the door closed and no one home.

Yes

Describe issues surrounding crate training

Allowed to roam free in house when you are not home? *

Yes

Supervised Only

Unsupervised

Allowed to run free in yard? *

Yes

Supervised Only

Unsupervised

N/A

Allowed on furniture? *

Yes

With Permission

How does your dog react when you leave? *

Have you seen any signs of Separation Anxiety?

Describe walking on a leash: *

Tell more all bout your walks, good and bad, how long and frequent are they.

Do you let your dog meet other dogs on leash? *

Yes

If yes, how does it go?

What kind of collar or harness are you using or have used in the past? *

Front/back clip harness, flat collar, martingale, choke, english slip lead, pinch/prong, E-collar

How does your dog react to other animals? *

Cats, birds, squirrels, etc.

Does your dog play off leash with other dogs? *

At Day care, a fenced in or off leash hours at parks, "Play Dates" at your or a friends/family home…

Yes

If yes, how does your dog do during off leash play and socialization?

How does your dog react when strangers approach your home, yard, or out in public?

Is your dog startled or scared of loud noises? *

Thunderstorms, fireworks, loud trucks, buses, carts, skateboards etc…

Yes

If Yes describe:

Is your dog sensitive to any parts of his/her body being touched? *

Ears, mouth, paws, nails, backend, etc

Yes

If yes, explain:

Is your dog possessive of or ever growled/snapped over food, toys or other objects? *

Yes

If yes, please describe the incident/s

The more information you can give the better.

Has your dog ever growled at someone? *

Human or Dog, other than over an object discussed above.

Yes

If yes, please describe the incident/s

The more information you can give the better.

Has your dog ever bitten someone? *

Yes

If yes, please describe the incident/s

Did the bite break skin? The more information you can give the better.

Does your dog obsessively: *

Bark

Dig

Jump

Chew

Mouth

Chase their tail

N/A

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? *

Thank you for taking the time to complete this form, the more information I have the better I can help you.

All appointments scheduled will require a 24 hour notice of cancellation by the owner or will otherwise be charged at full price. Exceptions will be made for emergency / medical circumstances.

If the client chooses to terminate the training contract and discontinue training after 50% of training has been completed, NO refund will be issued.

If the trainer feels that the client will not listen to training instructions / advice, the trainer can at their own discretion terminate the contract and discontinue training with the client at ANY point in time throughout the training period. A partial refund for the services remaining will be issued.