SPH Private Training Registration Form

Private Training Registration Form

Please complete all relevant sections
Contact Information

Required
Name

First Name Last Name
Address
City, Province
Postal Code
Phone Number
Please enter a valid phone number.
Email address
Emergency Contact
Full Name:

First Name Last Name
Phone Number:
Email:
Canine Information

Required
Dog's Name:
Breed:
Date of Birth (DD/MM/YY):
Sex:

Intact Male Neutered Intact Female Spayed
Colour:
Weight (kgs):
Where did you obtain your dog from?

Rescue/ Shelter Breeder
Other: Please Specify
How long have you had your dog for?
Please list all other pets in the household:
Canine Medical Information
Current Vet Clinic
Vaccine History

Required
DA2PP (Most recent)

First Booster 2nd Booster Final booster
Date given: (DD/MM/YY)
Rabies (DD/MM/YY)
Bordetella (DD/MM/YY)
Please attach all relevant vaccine records:

Cancel of
Diet
What kind of food are you feeding your dog?
How much are you currently giving them?
Please list their eating habits: How many times per day? Are they food motivated? etc..
Please list all known allergies
History & Background
Please list all other human members in the household:
If applicable
Do you have any concerns regarding their relationship with your dog? If yes, please list them:
If applicable
What types of exercise does your dog get on a typical day? (Leash walks, off leash, dog park, daycare, play time, etc..) Please also include approximate duration.
How would you describe your dogs energy level?

Low Moderate High Extremely high
Where does your dog sleep at night?
Where is your dog kept when you are not at home?
How does your dog do in the car?
What type of leash/ collar/ harness are you using?
Does your dog walk nicely on leash?
Has your dog had any other training? (Choose all that apply)

Group Classes Private Training Off site trainer Other
What cues does your dog know? (Choose all that apply)

Their Name Sit Down Come Stay Wait Leave it Drop it Place/ bed/ crate Off
Please list 3 things you wish your dog would learn
Please list 3 things you wish your dog would not do
Please check all behaviors that apply to your dog

Reactive/ Aggressive towards people Reactive/ Aggressive towards other dogs Fear Reactive Separation Anxiety Destructive Behaviour Excessive Barking Jumping Pulling on leash Jumping on furniture Nipping/Mouthing Chews furniture Play Biting Bladder control Steals food/ objects/ etc Bolts out of doors/gates Guards food/ toys/objects Excessive attention seeking Eats feces Stubbornness Bite history Selective with certain people Leash Reactive Prey Drive
Other undesirable behaviors (Please Explain)
Please describe any other information or concerns that you feel we would benefit from knowing about your dog:
Should be Empty:

Private Training Registration Form

Contact Information

Emergency Contact

Canine Information

Canine Medical Information

Vaccine History

Diet

History & Background