Piper's Place Dog Training Contact Form
Please complete this form to get started with Piper's Place Dog Training. If you are registering more than one dog, please complete a separate form for each dog. Thanks!
Name
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First Name
Last Name
Phone Number
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-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
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Friend/Family
Web search
Facebook
Instagram
Wags & Walks Nashville
Other
What type of home do you live in?
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Single family home
Apartment
Condo
Duplex
Other
How many adults live in the home with your dog?
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How many children live in the home with your dog and what are their ages?
*
What other pets live in your home? Please list species, age, and sex.
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Dog's Name
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Dog's breed(s)
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(Or best guesses)
Dog's age
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(DOB or approx. age)
Dog's sex
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Dog's weight
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Is your dog spayed/neutered?
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Yes
No
Where did you get your dog?
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Breeder, shelter, rescue, etc
How long has your dog been with your family?
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Veterinarian's Name
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Veterinarian's Phone Number
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-
Area Code
Phone Number
Is your dog on medication?
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Yes
No
Please list: medication name, dose and time(s) of day it is given
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Does your dog have allergies?
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Yes
No
If yes, please list allergies here. Please also include any other important medical history and information we should know about your dog.
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What type and brand of food does your dog eat and what is your dog's feeding schedule?
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WE REQUIRE EVERY DOG WHO TRAIN WITH US TO HAVE UP-TO-DATE VACCINATION RECORDS. Your dog needs to be up to date on the following: *Rabies, *Distemper, *Parvo and *Bordetella vaccines + *a recent negative fecal float. Please upload your dog's vaccination record or email a copy to dog@pipersplacedogtraining.com. FOR PUPPIES: If he/she is not old enough to be fully vaccinated, please upload their most recent vaccine record.
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Which training program are you interested in?
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Please Select
Puppy Kindergarten
Beginner Training Camp
Advanced Training Camp (off-leash)
Behavior Rehab Retreat
Day School
Puppy Hybrid Camp
Intermediate Hybrid Camp
Private Training Memberships
Why are you seeking training for your dog? What are your training goals for your dog?
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Has your dog had any prior training? If yes, please explain.
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Is your dog crate trained? This means calm and quiet in the crate. If you chose other, please explain.
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Yes
No
Other
Does your dog have accidents in the crate?
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Yes
No
Other
Has your dog ever chewed or eaten bedding while in the crate?
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Yes
No
Other
Does your dog sleep in your bed?
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Yes
No
Other
Does your dog sleep in a crate at night?
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Yes
No
Other
Where is your dog when you leave your house?
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Free roam of the house/not confined
Stays outside in yard
In the crate
In playpen/xpen
Other
Will you be comfortable following Piper's Place Dog Training's recommendation of crating your dog when you're not home when they return home from training?
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Yes
No
Does your dog live primarily inside or outside?
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Inside
Outside
Where does your dog go potty?
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Outside
Inside on pee pads
Not potty trained
Behavioral concerns - Check all that apply to your dog (please explain any details below):
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Puppy nipping/mouthing
Biting (no blood drawn or medical attention needed)
Biting (medical attention required)
Jumping on people
Pulling on the leash
Begging for table food
Excessive barking in the house
Excessive barking/nonsense in the crate
Destructive (chews/eats your personal items or property)
Reactive to other dogs (barking, lunging, etc)
Reactive to people inside the home/property
Reactive to people outside the home/property
Muzzle and/or sedation needed at groomer or vet
Growls over food
Growls over toys
Growls over space (kitchen, couch, bed, etc)
Growls over you or other member of the house
Fights with other animals in the home
Fights with other animals outside the home
Eats feces
Marks inside the house
Reliably potty trained
Crate trained
Regularly crated
Doesn't ride well in vehicles
Doesn't do well with nail trims
Shows anxiety or fear
Scared of loud noises (ex: fireworks or thunder)
Doesn't come when called
Doesn't listen to cues (sit, down, etc)
Other
Please explain any details from the behavioral concerns checklist if needed: *If your dog displays any aggressive behavior, please explain those behaviors in detail.
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If you have tried to stop your dog's unwanted behaviors, what did you do? Did it help with the unwanted behaviors?
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What are at least 3 qualities about your dog that you love?
Please check which of the following your dog is motivated by:
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Food/treats
Toys
Play
Praise
Other
What commands does your dog know? (Please only check the commands that your dog responds to 90+% of the time.)
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Sit
Down
Come/Here
Stay
No
Place
Kennel/Crate
Heel
Release word
Leave it/drop
Tricks (shake, sit pretty, touch, etc)
Other
What do you hope to accomplish with your dog during training? What are the most important things we could teach your dog to help you live the happiest life possible with your dog?
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Signature
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Date
*
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Month
-
Day
Year
Date
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