New Customer Registration Form

Thank you for taking the time to fill out this form. The information here will help guide me in creating a training planned tailored to the needs of you and your dog.

Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail*

example@example.com

Dog's name*

Dog's Age

Dog's breed

Dog's gender, spayed or neutered?

How long have you had your dog? Where did they come from, shelter, breeder etc.

Does your dog have any food allergies?

Does anyone in the home have any severe allergies (peanuts etc.)?

What are your top 3 training goals - behaviors you'd like to teach or change (when describing behavior observations such as "my dog plants on walks when we head towards home" rather than "my dog is stubborn" will help me better address your needs

Briefly describe your dog's typical daily routine (exercise, training, play, feeding schedule)

Have you consulted with any other trainers? What training, if any, have you done with your dog?

List the names of any other humans who live in the home, please include the ages of any children.

List any other non human animals, their names, age, gender, and species, who live in the home

Has your dog ever bitten or nipped another person or dog? If yes please describe in as much detail as possible (outside of normal puppy nipping or mouthing during play)

Has your dog ever shown any hesitation or fear towards any specific stimuli or handling? Fireworks, men in hats, balloons, grooming etc. What do they do when they encounter these stimuli? Back away, snarl, cower etc.

Please describe any other behavioral concerns you think I should be aware of

What are your expectations of dog training?

Any other questions or comments you'd like to address

How did you find out about Being Companions?

Being Companions Animal Training