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?*

What is your preferred method of contact?

Phone CallText MessageEmailOther

Dog Information

Dog's Name*

Breed*

Age*

Weight*

Gender*

MaleFemale

Is Your Dog:*

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?*

Does your dog attend daycare? If so, where and how often? *

Behavior and Training History

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

Does your dog have any previous formal training? *

Please place a check mark next to any tools that you have *previously* used with this pet.

Please place a check mark next to any tools that you are *currently* using with this pet.

Has your dog ever bitten a human or another dog for any reason?*

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.*

Other Information

Please list the names, ages, gender, and species/breed of any other PETS living in your home. If applicable, please note whether or not your dog gets along with the other pets in the home. *

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

Veterinary & Health Information

Veterinarian*

Vet Clinic*

Is Your Dog Current On All Vaccinations Including Rabies?*

YesNo

Is Your Dog Current On All Vaccinations Including Rabies?*

YesNo

Please Provide Proof of Vaccination:

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What kind of food do you feed your dog? *

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

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

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

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

Additional Information or Concerns:

Barks and Rec, Inc.