Service Dog Training Inquiry Form

Service Dog Training Inquiry Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
What types of service tasks would you like your dog to perform? (If you are unsure, tell us a bit about your daily needs and what types of tasks are affected by your disability.)
In which locations would you like your service dog to perform tasks?

Other
How much time are you able to commit on a daily basis to training your dog?
Do you currently have a dog that you would like to train to perform service tasks? (If not, we may be able to help with finding a dog with the right temperament for your needs.)
If you do not already have a dog you are wanting to train, please scroll to the bottom and submit.
Dog's Name
Dog's Breed
Dog's Age
Dog's Gender
Is your dog spayed or neutered?
Where did you obtain your dog?

Other
How old was your dog when they came to your home? (With puppies, please state as accurately as possible as age impacts behavior significantly. For dogs brought home as adults, approximate age is fine.)
List any of your dog's food allergies or foods we should avoid bringing into your home.
If your dog has any medical issues, please describe them here.
What brand of food does your dog eat?
What type of exercise does your dog get and how often?
Which cues does your dog already know?

Other
Has your dog participated in professional training (classes or lessons) before?
Has your dog ever growled or snapped at a person?
Has your dog ever bitten a person?
Has your dog ever growled or snapped at a dog?
Has your dog ever bitten a dog?
If you answered yes to any of the questions above about growling, snapping, or biting, please explain the circumstances of the incident(s) below, the severity of the bite (if applicable) and whether medical attention was needed.
Do any other animals live with you?
Have any of the other animals in your home ever bitten a person or another animal? (While this may not be relevant for training, we need to have this information before entering your home for our safety.)
Is there anything else you feel would be important for us to know about you or your dog?
PAYMENT: Payment is due prior to each lesson. No refunds will be given for lessons which have already taken place.

LIABILITY: Owner understands that Pawsibilities and Trainer Melissa Childs make no guarantees regarding the outcome of training. Owner understands that Pawsibilities, Trainer Melissa Childs and Trainer’s employees/agents are not responsible and cannot be held liable for any loss, damage or injury to persons, animals or property arising from or related to Owner’s pet. Owner agrees that Trainer shall not be liable for loss or damage to animal for any reason. If pet causes property damage, or bites or injures any animal or person, during or after training, then Client agrees to pay all resulting losses and damages suffered or incurred.

By submitting this form, you are indicating your understanding of and agreement to the policies listed above.
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Service Dog Training Inquiry Form

If you do not already have a dog you are wanting to train, please scroll to the bottom and submit.