Dog Training PAQ

Owner Information

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

How did you hear about us?*

Dog Information

Dog's Name*

Breed*

Age*

Weight*

MaleFemale

SpayedNeuteredIntact

When Did You Acquire Your Dog?*

How Old Was The Dog When You Acquired Him/Her?*

Where Did You Adopt/Purchase Your Dog From?*

Please list the names, ages, gender, and species/breed of any other PETS living in your home.*

Please list the names and ages of any other HUMANS living in your home. Please also note each person's relationship to the dog. *

Describe the behavior concerns that you are experiencing with your dog. What prompted you to seek out training assistance?*

YesNo

If you answered "yes" to the above question, how severe was the bite? Was medical attention needed? Please provide information regarding the circumstances of the bite.

Please list your top 3-5 goals for what you'd like to accomplish through training.*

Veterinary Information

Veterinarian*

Vet Clinic*

YesNo

Please Provide Proof of Vaccination:

Browse Files

Please List All Medications Your Dog Is Currently Taking. Please Include Heartworm, Flea and Tick Medications, etc*

Additional Health Questions:

What kind of food do you feed your dog? *

How much and how often do you feed your dog? *

What kind of bowl does your dog eat out of? *

Please List Any Medical Problems Your Dog Has Had, including any Food Allergies:*

Food allergies, chronic pain or illness, recent surgeries, genetic abnormalities, etc.

Additional Information or Concerns:

Barks and Rec, Inc.