Reactive Dog Class Signup

Reactive Dog Class

Please fill out this form in entirety to ensure we can provide your pet with the best possible care.
Pet's Name*

First NameLast Name
What is your pet's Breed?
Breed
How old is your pet?
Age
What is your pet's Birthday?

MonthDayYear
Date
Your Name*

First NameLast Name
Email
example@example.com
Contact Phone*

Area CodePhone Number
Anything specific you want to work on?
This course is a 6-week Course for dogs who have varying degrees of reactivity that include barking, biting, running, and other issues. Please sign up for the first day and know that the rest of the classes are at the same day, time and place 1 week later for a total of 6 weeks.
This course is a 6-week Course for dogs who do not have varying degrees of reactivity that include barking, biting, running, and other issues. This class is to help with learning more skills and manners in a home or in public. Please sign up for the first day and know that the rest of the classes are at the same day, time and place 1 week later for a total of 6 weeks.
Appointment
If there are no appointment slots available you can call 309-981-5112 to see if we have any cancelations. Also fill out the waiting list form for quicker service. Thank you for your patience.
Does your pet have any allergies?

YesNoUnsure
If yes, please describe/provide more information
Mostly we are worried about food allergies and treats given
When Was Your Pet's Last Dose of Flea/Tick Preventative?
Date Given (Please type N/A if not on a preventative)
What Kind of Flea/Tick Preventative Do You Use?
Name of medication - put unknown if not sure
Is Your Pet Current On Vaccinations?

YesNoI Am Not Sure
My pet's vaccines were administered last by:

I Am Not Sure WherePrairie Animal HospitalOther
Please Upload any Medical Records You May Have

Browse Files
Please upload if available. Cancelof
Does Your Pet Have A Microchip?

YesNoI Am Not Sure
Does Your Pet Have Known Health Concerns and/or Chronic Disease or Conditions that might affect training?
If yes, please tell us more. If no, please note N/A
Is There Anything Else We Should Know About Your Pet?
If yes, please tell us more. If no, please note N/A
Authorizations
I verify that I am the owner (or authorized agent for the owner) of the above named pet and authorize training and treats to be given by the trainer. I understand and will follow the trainers directiosn for the safety of all animal and people that come to class*
Initial
I agree to be responsible for providing us proof of vaccinations, negative fecal testing and to bring my own treats that my dog loves.*
Initial
Prairie Animal Hospital are leaders and teachers in their field. They often use video/picture in presentation, on the website and on social media avenues. I authorize the case/patient information for such purposes *
Initial
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Reactive Dog Class$175.00

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Reactive Dog Class

Authorizations