Dog Training Request Form

1
NamePlease enter your first and last name.
First Name
Last Name
2
Phone NumberPlease provide a phone number. This phone number may be used in cases of emergency, as a regular communication method (if this is your chosen method), or to help serve our records.
Please enter a valid phone number.
3
EmailPlease enter an email you check regularly to receive important information regarding training.
example@example.com
4
AddressPlease enter your address.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
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Ghana
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Greece
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Guam
Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
How do you wish to be contacted?Messenger, Text, Call, Email, Etc.
6
What services are you most interested in?If other, please describe in notes section at the end or training goals.
Board and Train (limited availability)
Private Training Sessions
Puppy Group Classes (not for aggression or behavioral issues)
Adult (over 8 months) Group Classes (not for aggression or behavioral issues)
Behavior Modification
Aggression Rehabilitation
Other
7
Dog's Age and Date of BirthPlease answer to the best of your knowledge. Adoption dates are also acceptable if you are unsure as to exactly how old your dog is.
8
At what age did you get your dog?
9
Where did you get your dog?Please specify whether from a breeder, shelter, or other means. Breeder/Shelter names are not necessary.
10
Is your dog currently on any medications?Please provide medication name as well as dosage and primary use. Daily vitamins or other supplements are optional.
11
Has your dog ever been on any anxiety medications?If yes, please annotate dosage, prescription name, as well as usage.
12
Does your dog have any medical conditions we should be aware of?Please list conditions specific to training: bloating, allergies, seizures, etc.
13
Vet InformationPlease provide your veterinary practice's name and phone number. This will be used in emergencies only and/or to verify records (if necessary).
14
How often do you walk your dog? Number of times per week, and approximately how long?
15
Does your dog pull on the leash?
YESNO
16
Would your dog run away given the opportunity?
YESNO
17
Do you ever walk your dog off leash?
YESNO
18
Has your dog ever been to the dog park or doggy daycare?If yes, how often?
19
Does your dog jump on you or other people?
YESNO
20
Does your dog follow you around the house?
YESNO
21
Does your dog get along with other dogs?
YESNO
22
Does your dog like meeting new people?
YESNO
23
Has your dog ever shown any signs of aggression? If yes, please explain.
24
Has your dog ever bitten or drawn blood?If yes, please explain.
25
Has your dog ever shown signs of aggression around food, toys, water, and/or other resources?If yes, please explain. Please include whether the situation(s) involved humans or other dogs..
26
Has your dog ever shown signs of anxiety?This includes weather related, separation, crate anxiety, etc. If yes, please explain the situation as well as what you do during the episode.
27
Does your dog bark at new people?
YESNO
28
Does your dog bark at other dogs?
YESNO
29
Do you crate your dog?
30
Where is your dog's crate located?
31
How often does your dog spend time alone?
32
Does your dog do well when left alone?
33
have you ever used training tools on your dog?e-collar, slip leash, prong collar, corrector spray, etc.
34
Have you ever utilized a professional trainer before?If yes, please explain the duration of training and what was taught.
35
What are your training goals?
36
Is there anything else you would like to mention about your dog that has not already been covered in this form?
37
Notes:if nothing, please respond N/A.
38
Please upload a copy of your dog's vaccination record. We require rabies, DA2PP, and bordetella (6 month preferred, 12 month accepted).Vaccination records can also be emailed to bevillsadvocatetraining@gmail.com or given at the start of training.
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39
I understand that Bevill's Advocate Dog Training ("BADT") is a balanced training program which utilizes tools such as e-collars, prong collars, slip leashes, correction spray, etc. By signing my name I agree to allow these tools to be used properly during training and understand that a member of BADT will show me how to correctly utilize my training tools. I understand that I must purchase training tools in order for my dog to be completely successful. If I should choose not to purchase training tools, I assume the responsibility of the outcome. If there is ever a time where I do not feel comfortable or I am unsure, I will immediately contact BADT and inquire as to how to proceed.Please sign your name below.
Clear
40
Thank you for taking the time to fill out our training application! We appreciate your interest as well as your feedback. If there is anything we can do to help you in the meantime, please send us a message on Facebook. To secure a spot for training, there is a 50$ (USD) deposit required. This is a nonrefundable deposit. This deposit will go towards your remaining balance. We accept Venmo, Cashapp, cash, or check. WE DO NOT ACCEPT CARDS AT THIS TIME. I apologize for any inconvenience this may cause. If you have any questions about our policies, please feel free to send us a message.
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