Training & Wellness Center - Private Training Inquiry Form
Please fill out the following information to be matched with a trainer and schedule a training consultation. **Our address is 1608 North Lynhurst Drive in Speedway. ** We do not share the same facility as the Daycare, Boarding, & Grooming Facility. NOTE: We only offer basic training for foundation skills such as manners, leash walking, and polite greetings. We are unable to take reactivity, aggression, seperation anxiety, extreme fear, and other behavior modification cases. If you are experiencing these issues, we recommend finding an appropriate (and local) trainer or behavior consultant on www.trainhumane.org.
Customer Details:
Full Name
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First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
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Facebook
Google Search
Customer Referral
Vet Referral
Other (Please specify)
Other
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
Dog's Information
We can't wait to meet them!
Dog's Name
*
Dog's Breed or Mix
*
Dog's Weight
*
Date of Birth (or guess)
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Month
-
Day
Year
Date
Choose One:
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Spayed Female
Intact Female
Neutered Male
Intact Male
Veterinarian
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First Name
Last Name
Veterinarian's Phone Number
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-
Area Code
Phone Number
Your vaccine records must be emailed to puppypitstoptraining@gmail.com. Dogs should be up to date on Bordatella, Distemper/Parvo, and Rabies before entering the center.
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I understand and will email you their vaccine records within 7 days.
My dog is not up to date on the listed vaccinations.
How long have you had your dog?
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Please list any allergies:
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**Also note if a human in the home has a peanut butter allergy as we sometimes use it for training!
Is your dog social towards people they don't know?
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Yes, very social towards people
Selectively social towards people
Scared of new people
Aggressive towards new people
Is your dog social or tolerant towards other dogs?
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Yes, my dog likes or is OK with other dogs
No, my dog is reactive towards other dogs
Unsure
Please give a brief summary of your training goals. (i.e. Polite greetings, "stay", better leash walking skills, etc) This allows us to match you with a trainer. Please note: We do not offer training for aggression, reactivity, seperation anxiety, or other advanced behavior modification cases at this time.
Has your dog ever had any training before? If so, where or with whom?
What is your availability for sessions? Flexible, Daytime, Evening, Weekend, etc.
I understand that by filling out this form I am submitting an inquiry for training. After review, a trainer will be in contact within 72 hours to setup a consultation. If appropriate, cases will be referred out to other local trainers based on current caseload and/or training goals.
I understand this is only an inquiry and have read the statement at the top of this page thoroughly.
By signing, I hereby release "Puppy Pitstop" and "the trainers of Puppy Pitstop Training & Wellness Center", of all liability related to illness, injury, or otherwise as a result of training on or off-site. This form serves as an inquiry, whereas a trainer will reach out to schedule a consultation. Payment is due at time of scheduling consultation to reserve your appointment.
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