Blue Dingo - Training Intake Form

Blue Dingo Dogs

Training In Take Form
Owner Name*
Date

MonthDayYear
Phone #*
Email*
example@example.com
How did you hear about us?
Dog's Name*
Dog's Date of Birth or Approximate*
Dog's Breed (or mix)*
Date of Adoption/Purchase*

MonthDayYear
Is your dog spayed/neutered or intact?*

Spayed/NeuteredIntactOther
Where did you acquire your dog? I.E., rescue, breeder, shelter, family friend,*
Does your dog have any food allergies or medical conditions?*
Any current medications?*
Vaccination Expiration Dates:
Rabies exp date*

MonthDayYear
Distemper/Parvo/ Lepto exp date

MonthDayYear
Kennel Cough exp date

MonthDayYear
How does your dog react when approached directly by an unfamiliar person while being walked on leash? *
How does your dog react when approached directly by a household member while eating?*
How does your dog react when food is taken away by a member of you household?*
How does your dog react when an unfamiliar person tries to pet them? *
How does your dog react when toys/objects are taken away by a member of you household?*
How does your dog react when approached directly by an unfamiliar dog while on leash?*
How does your dog react when strangers walk past your home?*
Is your dog crate trained? Are they quiet and relaxed in the crate with out barking, digging or crying?*

YesNoOther
Below is a list of training tools, please check off any that you have used:*

Flat collarMartingale CollarPinch/Prong collarHead harness/ Gentle LeaderSlip lead/ choke collarFront clip harnessNormal HarnessBark collar (citronella spray)In Ground fence collarElectronic collar/ E-collarFood rewardsClickerOther
Second Dog's Name
Dog's Age
Dog's Breed (or mix)
Where did you acquire your dog? I.E., rescue, breeder, shelter, family friend, etc.
Is your dog spayed/neutered or intact?

Spayed/NeuteredIntactOther
Date of Adoption/Purchase

MonthDayYear
Date
Does your dog have any food allergies or medical conditions?
Any current medications?
Vaccination expiration dates:
Rabies exp date

MonthDayYear
Distemper/Parvo/ Lepto exp date

MonthDayYear
Kennel Cough exp date

MonthDayYear
Is your dog crate trained? Are they quiet and relaxed in the crate with out barking, digging or crying?

YesNoOther
How does your dog react when approached directly by an unfamiliar person while being walked on leash?
How does your dog react when food is taken away by a member of you household?
How does your dog react when toys/objects are taken away by a member of you household?
How does your dog react when approached directly by a household member while eating?
How does your dog react when approached directly by an unfamiliar dog while on leash?
How does your dog react when an unfamiliar person tries to pet them?
How does your dog react when strangers walk past your home?
Below is a list of training tools, please check off any that you have used:

Flat collarMartingale CollarSlip lead/ choke collarPinch/Prong collarHead harness/ Gentle LeaderFront clip harnessNormal HarnessBark collar (citronella spray)In Ground fence collarElectronic collar/ E-collarFood rewardsClickerOther
Has your dog(s) received professional training? *
If yes, where?*
What kind(s) of training have you tried? ie private lessons, group class, online, etc *
How did you feel about the experience?
What lead you to look for a new trainer? *
What training tools do you currently use, if any? *
What do you do for exercise for your dog and for how long?*
Do you do any enrichment activities (walks, hikes, classes, feeding toys, etc)? if yes please describe*
Is your dog comfortable having a collar put on and taken off?*
Is your dog comfortable having a leash put on and taken off?*
Is your dog comfortable being picked up, petted, or restrained?*
Has your dog ever had bitten or snapped at a person? (Including groomer, vet staff, visitors to your home, etc.)*
What was the situation that cause the dog to bite or snap at the person? Did they make contact or break skin? *
Is your dog muzzle trained? *
Is your dog comfortable around other dogs and people? *
Has your dog ever had bitten or snapped at another dog? *
Is there anything else we should know about your dog?*
What behaviors do you want to work on? Check all that apply.*

Paying AttentionSitDownStayComing when calledJumpingLeave itCounter SurfingSeparation AnxietyReactivity to dogsReactivity to humansLoose leash walkingFear/AnxietyService dog tasks
Any other behaviors or skills you would like to work on?
Do you have a particular day or time that works better for you for lessons?
Our certified professional trainers do not reccomend or utilize prong collars, slip leads, choke chains, electronic collars, spray bottles, air cans, or shake cans in training. By submitting this form you understand that at no time will our trainers reccomend or use those tools while working with you and your pet.
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Blue Dingo Dogs