Client Information

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*

Emergency Contact*

First NameLast Name

Phone Number*

Area CodePhone Number

How Did You Hear About Us?*

Have You Ever Owned A Dog?*

Briefly State What You Hope To Accomplish During Training:

Dog Information

Dog's Name*

Breed*

Age*

How Old Was The Dog When You Acquired It?*

Gender*

MaleFemale

How Long Have You Owned The Dog?*

Has Your Dog Been:*

SpayedNeuteredNone of the Above

Where Did You Acquire Your Dog?*

Where Does Your Dog Sleep At Night?

Is Your Dog House Trained?

Behavior Problems Of Parents Or Littermates, if Known?

Veterinary Information

Veterinarian

Vet Clinic

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Is Your Dog Current On All Vaccinations Including Rabies?*

YesNo

Vaccination Dates:

Rabies:*

DHLP:*

Bordetella *

Please List All Medications Your Dog Is Currently Taking. Please Include Heartworm, Flea and Tick Medications, etc*

Please List Any Medical Problems Your Dog Has Had:*

Does your dog have any allergies? If so, please list those here:*

Behavior Information

Describe Any Previous Obediance Training:

Level Of Success?

What Commands Currently Work Best?

Which Member Of The Family Has The Best Control?

Does Your Dog Know How To Walk On A Leash?*

YesNo

How Does Your Dog Respond To The Following Tasks?

Trimming Nails?*

Giving Pills?*

Cleaning Ears?*

Grooming?*

Bathing?*

Patting Head?*

Grasp Collar?*

Being Lifted?*

Tell Me About Any Correction Techniques You Have Used And Their Effect On Your Dog’s Behavior:

Time Out*

Leash Correction*

Verbal Scolding*

Noisemaker*

Water Spray*

Other*

Other Description, If Needed:

Behavior Problems:*

Describe Unwanted Behavior In Greater Detail:*

Describe How Your Dog Reacts To The Following Times When Left Alone:

During The Day:

During The Evening:

What Is Your Dog's Reaction To Your Departure?*

What Is Your Dog's Reaction To Your Homecoming?*

Do You Use A Crate?*

YesNo

Does Your Dog Like The Crate?*

YesNo

Does Your Dog Exhibit Any Of The Following Behaviors, and When Does It Occur (Ex: Towards Men Or In The Car)

Cowering

Ears Back

Tail Tucked

Retreating

Hiding

Excessive Salivating

Pacing

Please Give Additional Information Regarding Fear Or Anxiety In Your Dog:

Describe Situations Where Your Dog Appears Fearful And/Or Aggressive:

Do You Ever Muzzle Your Dog For Safety?*

YesNo

Is Anyone In Your Family Afraid Of Your Dog? If So, Please Describe:*

How Does Your Dog Respond To The Following Situations?

When Approached While Eating:*

When Approached With Treat Or Toy:*

When Dog Is Scolded:*

When Dog Is Approached While Sleeping:*

To Strangers Outside Of The House:*

To People Entering House/Yard:*

To Children Or Infants:*

While In Car To People Outside Of The Car:*

To Other Dogs In Your Home:*

To Other Dogs Outside Your Home:*

Ever Aggressive Towards Family Members?*

YesNoSometimes

If yes, Please Explain:

Has Your Dog Ever Bitten A Person?*

YesNo

If yes, Please explain:

Has Your Dog Ever Been Reported To Animal Control For Biting?*

YesNo

If yes, Please Explain:

PLEASE GIVE A 24 HOUR NOTICE FOR ANY CANCELLATIONS OR CHANGESTO YOUR APPOINTMENT

AGREEMENT TO HOLD HARMLESS, WAIVER AND ASSUMPTION OF RISK

I understand that attendance of a dog obedience training class or playcare is not without risk to myself, members of my family or guests who may attend, or my dog, because of some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby waive and release Familiar Friends hereinafter referred to as the "Training Organization", its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.

I hereby certify that my dog(s) is/are in good health and has/have not been ill with any communicable conditon in the last 10 days. I further certify that my dog(s) has/have not harmed or shown aggressive or threatening behavior towards any person or any other dog. I have read and understand the following:

I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending Familiar Friends.
I further understand and agree that in admitting my dog(s) to Familiar Friends, the staff have relied on my representation that my dog(s) is/are in good health and has/have not harmed or shown aggressive or threatening behavior towards any person or any other dog.
I further understand and agree that Familiar Friends and their staff will not be liable for any problems that develop, provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind whatsoever arising from my dog’s/dogs’ attendance and participation at Familiar Friends.
I further understand and agree that dogs can sometimes receive minor cuts and scratches during daycare and boarding, and any problems that develop with my dog(s) will be treated as deemed best by staff of Familiar Friends, at their sole discretion, and that I assume full financial responsibility for any and all expenses involved.
I further understand that if my dog is not picked up on time or by date specified in a separate agreement I hereby authorize Familiar Friends to take whatever action is deemed necessary by staff and assume full financial responsibility for the cost of continuing care for my dog(s).
I further understand that if I do not pick up my dog(s)on the date specified and provide no contact that Familiar Friends will proceed with handling according to guidelines provided by Texas Penal Code 42.092. I also acknowledge that I will be fully responsible for all attorney fees and associated costs if I abandon my dog(s).

By signing this agreement, I have read and understand the contract set forth by FAMILIAR FRIENDS LLC.*

By Clicking The Submit Button You Agree To The Above Terms