Clipper & Blades Canine Services
Please complete this intake form with as much detail as possible and click submit at the end. Once assessed we will be in touch to discuss an in-person appointment / class start date.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
E-mail
example@example.com
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Please specify which service you are enquiring about in the box below (Puppy Class Blyth, Puppy Class Widdrington, Canine Club Blyth, 1-2-1 Training, 1-2-1 Behaviour Modification, Training Walks, Gradual Grooming Programme, Training Workshop etc)
What is your dog's name?
How old are they (to your knowledge)? Please provide date of birth if known
What breed are they (to your knowledge)?
Which Vet are they registered with?
Has your dog had their puppy immunisations?
Yes
No
Is your dog microchipped? (This became a legal requirement from April 2016)
Yes
No
Is your dog neutered / spayed?
Yes
No
Other
What are you hoping to achieve with professional dog training?
Please provide, in as much detail as possible, your dog's history prior to you owning them. If bought as a puppy this will include the environment they were raised in, the temperament and health of the parents, your pup and siblings (if known). If rehomed or rescued, please provide what information you were given about your dog.
Please provide details of any pain, illness or disease your dog has had or is currently suffering with. This could include any concerns your vet has raised but asks that you monitor for the time. Please also include any special measures that were / are being taken - including medication, dietary, exercise and lifestyle changes to manage their condition (if applicable).
Has your dog ever bitten a human, dog or other animal? Please provide details of any incidents if applicable (does not including mouthing / teething / redirected play)
Where does your dog sleep and how often throughout the day do they choose to sleep?
How many hours on a typical day does your dog spend alone?
What does your dog eat and how often?
How does your dog respond to new people / environments?
Please list 5 things you love about your dog
What tricks / cued behaviour does your dog currently know? (Eg. Sit, stay, paw, go to bed)
What things cause a negative response from your dog or appear to make them uncomfortable? (Eg. Postman, hoover, balloons, people in hats)
I am happy for photos / videos of myself and my dog to be used on social media to promote the services offered by Clipper & Blades Canine Services.
Yes
No
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