Name
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Phone
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(###)
###
####
Email
*
Address, City, Zip Code
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Emergency Contact Name and Phone #
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Dog's Name, Breed, and Date of Birth
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Sex
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Female
Male
Spayed/Neutered
Veterinarian Clinic
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Is your dog current on vaccinations? (DA2PP, Bordetella, Rabies)
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Please email us a current copy of vaccines with Due Dates.
Yes
No
Has your dog had a fecal exam within the last 6 months?
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If no, please let us know as we provide this service, If yes we will need a copy of the report.
Yes
No
When was your dogs last vet visit and for what?
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How does your dog behave at the vets office?
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Excellent
Fair
Bad
What services are you interested in?
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Consulation
Board & Train
Private Lessons
Group Classes
Service Dog Training
How did you hear about us?
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What are your top 3 behavior conerns for your dog?
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Have you worked with another trainer? If so, what training company?
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What brand of food do you feed your dog?
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How much food do you give your dog and how often?
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Does your dog sit and wait to be released for meals?
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Yes
No
How long does it take for your dog to eat?
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Where did you you get your dog and how long have you had him/her?
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What attracted you to get this dog/breed?
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Are there any other animals in the household? If yes, species, breed, age.
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How much time do you have to train your dog each day?
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I am way to busy to train my dog
20 minutes
40 minutes
1 hour
As much time as needed
What collars you have used or tried previously? Please check all the apply.
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Buckle, nylon, leather
Prong
Martingale
Choke Collar
Electronic Collar
Body harness
Head harness
Other
What side does your dog walk on?
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Left
Right
Both sides
What Commands does your dog know? Select all that apply
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Place
Watch
Sit
Down
Stay
Come
Heel
None
What motivates your dog? What does your dog like?
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When you walk your dog and he/she see's another dog, what do they?
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When you greet another person what does your dog do?
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Has your dog lunged, growl or bitten another person or dog?
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Has your dog been to a dog park or day care?
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Is your dog crate trained?
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Yes
No
Where is your dog when you are not home?
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What activites/exercise do you provide your dog?
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Walks/Runs
Off leash walks/play
Fetch games
Tug games
Interactive toys
Rough housing
Backyard play
How would you describe your dog's activity/energy level?
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Low
Moderate
High
Intense
Please help me with? Check all that apply
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Barking
Digging
Jumping
Leash Pulling
Begging
Chewing
Chasing other dogs
Nipping
Biting
Growling
Seperation Anxiety
Aggression
Self Destructive Behavior
Fear Aggression
Anxiety
Attention Seeking
Resource Guarding
Improper Elimination
Is there anything els about your dog that we should know about?
*
Date
MM
DD
YYYY