Training New Client Form

Dog Training Client Form

To update our records please complete the following form:
Training Class you are interested in learning more about:*

Puppy PreschoolPuppy KindergartenAdolescent Obedience
Are you already an established Client with our Clinic or Pet Resort?*

YesNo
Owner Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number- Cell*
Please enter a valid phone number.
Phone Number- Home
Please enter a valid phone number.
Email*
example@example.com
Pet's Name: blanks* . Pet's Breed: blank*
Pet's Date of Birth:*

MonthDayYear
Date
Has your dog attended any prior training classes? (please list)
Medical Records:

If you are not an established client of our Clinic or Pet Resort, you will need to provide the following medical records in order to reserve a spot in any of our training classes.

* All students must be current on age-appropriate vaccines, including the kennel cough vaccine.

** Puppy Class students must have a recent negative fecal test or recent dewormer treatment.

Please email medical records to resort@brightoneggert.com or fax to (716) 424-1717. Records must be receive before we can reserve a spot in any class.
Form of payment being used to pay for training class (all classes must be paid in full prior to class start date)*

CashCredit Card
Payment

All professional fees are due at the time that services are rendered.

We accept Cash, Visa, Mastercard, Discover, American Express, Care Credit. We NO longer accpet personal checks. Returned checks are subject to a $49 returned check fee.

All balances are subject to a monthly finance charge. If it becomes necessary to send your account to a collection agency, you are responsible for all collection fees incurred.

To prevent the spread of infectious diseases, all pets must be current on vaccines and free from internal and external parasites. The signature below authorizes this level of preventative care.

We reserve the right to exclude your dog from class, if your dog is causing a disturbance to other pets, other owners, or if your dog is distracting the trainers from giving full attention to all class participants. Classes are non-refundable.

I HAVE READ THE PREVIOUS STATEMENT AND AGREE TO THE TERMS STATED:
Signature

Clear
Brighton Eggert Animal Clinic and Pet Resort has permission to use my pet's likeness in any digital media format (e.g., photo, video, website and other web-related publications) without payment.

YesNo
Signature

Clear
Should be Empty:

Dog Training Client Form