Dog Training Form

Please fill out this form to the best of your ability. I know it is long but this information will help me to better serve you!

Owner Information

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

How did you hear about me?*

Are there any children in the house?*

YesNo

If there are children in the house please specify ages.

Do you have other pets?*

YesNo

If there are other pets in the home please list them.

Dog Information

Dog's Name*

Breed*

Age*

How old was your dog when you adopted It?*

Gender*

MaleFemale

Where did you adopt your dog?*

How long have you had your dog?*

Is your dog spayed/neutered?*

YesNo

Do you use a crate for your dog?*

YesNo

Does Your Dog Like The Crate?*

YesNo

Is your dog potty trained*

Yes completelyOccasional accidentsNot at all

Where does your dog sleep at night?*

Please describe your dog's personality.*

Please describe the amount and type of physical exercise your dog gets.*

Please describe the amount and type of mental exercise your dog gets.*

What type of home do you live in (house, apartment, etc).*

When your dog is outside they are...*

Does your dog get along with other dogs?*

My dog is very dog social. Loves all other dogs!My dog is dog tolerant. Gets along with most dogs.My dog is dog selective. Has a few dog friends but is picky about new dogs. Some dogs make him/her nervous.My dog is dog aggressive. Does not like any other dogs at all.Unknown

Do your attend a dog park?*

Yes, oftenSometimesNo

Do your attend a dog daycare?*

Yes, oftenSometimesNo

Veterinary/Health Information

Vet Clinic*

Is your dog current on all vaccinations including Rabies?*

YesNo

Please list all medications your dog Is currently taking.

Please list any medical problems your dog has had, or currently has:

What kind of food does your dog eat:*

Any food allergies? If yes, what?

Please describe your dog's stool (normal? diarrhea issues?)*

Training & Behavior

What training tools or equipment do you use, or have you used on your dog (click on all that apply):*

Does your dog have any formal training (click on all that apply)?:*

If your dog has had formal training, with whom and where?

What are your goals for private training:*

How does your dog respond to the following?*

	I never do this	Loves it	No reaction	Moves away	Growls	Snap/ Bite
Trimming Nails
Brushing fur
Brushing Teeth
Cleaning Ears
When I pet my dog
When I hug my dog
If I lift my dog
Disturbed when sleeping/resting
Approached while eating
Take away something
Approached when has toy/chew item
Pushed off furniture

My dog knows...*

	Always responds	Sometimes responds	Does not know this at all
Sit
Lie Down
Stay or Wait
Leave-it
Drop it
Comes when called
Go to Bed/Mat/Place or Kennel on cue
Looks at me when I say his name

Any other cues your dog knows not listed above?

Have you ever punished/disciplined your dog?*

YesNo

If you answered yes, what happened and how did you punish the dog?

How did your dog respond to the punishment?

Behavior issues? (click on all that apply).*

Describe behavior Issue(s) in greater detail (if no behavior issues type NA):*

When did the behavior issues begin? How long have they been going on? (if no behavior issues type NA)*

Describe situations where your dog appears fearful and/or aggressive (if any):

Describe how your dog does when meeting new people.*

Is anyone in your family afraid of your dog? If so, please describe:

Has your dog ever bitten a person?*

YesNoUnknown

Has your dog ever bitten another dog?*

YesNoUnknown

Anything else you would like me to know?

What is your general availability? Please be as specific as possible! Days/Nights & Weekend availability including times). When are you hoping to meet?*

Thank you for filing out this form. I will contact you via your email address within 48 hours with an appointment time. Generally appointments can be scheduled within 3-4 weeks. If I cannot meet during your current availability I will offer alternate times/dates.

RELEASE OF LIABILITY: As the legal owner of the dog listed on this registration form, I do hereby waive and release, Radiant Canines/Robin Downing from any and all liabilities of any nature. I agree to take complete responsibility for the actions of my dog, and myself, before, after, and during appointments. At no time will the instructor or assistant or facility of Radiant Canines be liable or responsible for the actions of myself, my dog, or any other person who accompanies me to my appointment. Once training appointments have begun; all fees are non-refundable including training packages. Appointments cancelled within 24 hours of the appointment may be charged the appointment fee.

I acknowledge the contagious nature of the Coronavirus/COVID-19 and further acknowledge that Radiant Canines/Robin Downing can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others.
I voluntarily seek services provided by Radiant Canines/Robin Downing and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19, though Robin Downing has been fully vaccinated. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
I attest that:
* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* I have not traveled internationally within the last 14 days.
* I have not traveled to a highly impacted area within the United States of America in the last 14 days.
* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* I have not been diagnosed with Coronavirus/Covid-19.
* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

By Clicking The Submit Button You Agree To The Above Terms