New Client Form

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Name
First Name
Last Name
2
Email
example@example.com
3
Cell PhoneI encourage you to ask questions between sessions - via text message is the fastest way to get a response.
Please enter a valid phone number.
4
Home Phone
Please enter a valid phone number.
5
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
List other adults that will be involved with training
7
List any children in the home and their age
8
Dog's Name
9
Dog's BreedList mix of breeds if known, or just say mutt!
10
Have you done research on this particular breed, what they need to thrive in a human world, and what they were bred to do?
Yes
No
I have had this breed before and know their temperament and what they need.
11
Dog's AgeTake your best guess if necessary
12
List any known foods your dog does not tolerate.Are they allergic to chicken or some other form of protein?
13
How long have you had this dog?
14
Where did you get this dog?Was it a rescue? Was it a breeder?
15
How much of the dog's history do you know?If a rescue, list what they shelter told you.How old were they when you adopted them? If it was from a breeder list what they said they did with puppies while in their care. At how many weeks did you bring the puppy home?
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List all other animals, breed, species, age, gender, etc. that live in the household.
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With what behaviors do you want training?Try to be specific: I want my dog to not jump on guests. I want my dog to stop pulling on walks. etc.
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What behavior do you want them to perform instead of what they are doing currently. Ex: I want my dog to settle on a mat when guests enter my home. I want my dog. I want my dog to walk with a loose leash while going on a walk.
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Describe your dog's typical day and any rules you have for them. What happens with your dog from the time you get up until you go to bed? Rules could be things like not allowed on furniture, etc.
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20
List all previous training classes and methods of training you have used with your dog and how did they respond?
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21
What behaviors does your dog do willingly in the home?
Sit
Down
Come
Retrieve a ball
Drop it
Shake/High Five
Stay
Walk nicely on leash
22
What behaviors does your dog do willingly outdoors with distractions?
Sit
Down
Come
Retrieve a ball
Drop it
Shake/High Five
Stay
Walk nicely on leash
23
Vet's name & clinic at which they work.
24
Does your dog have any known medical issues?
25
Is your dog on any medications - why and for how long?
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What brand of food do you feed?
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What behaviors does your dog exhibit around strangers?Examples : They bark and stare with a stiff body. They bark and whine with a wiggly body. etc.
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28
What behaviors does your dog exhibit around unknown dogs?Examples : They bark and stare with a stiff body. They bark and whine with a wiggly body. etc.
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What behaviors does your dog display when a stranger enters the home? Where are they in relationship to the stranger? What does their body look like? How long does it take them to become comfortable with the stranger or settle down around the stranger?
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What behaviors does your dog display when they see a stranger on a walk or away from the home?Do they ignore? Do they stare until done passing? Do they pull towards the stranger? Etc.
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31
What do you use to walk your dog?
Standard flat buckle collar
Front Clip Harness
Rear Click Harness
choke collar
Prong Collar
Head halter
Martingale Collar
Other
32
Is your dog crate trained?
Yes
No
In progress
33
Does your dog seem upset or anxious when you leave them alone?If so, describe the behaviors you see; whining, barking, panting, etc.
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Do you take your dog to off-leash dog parks? If so, how often?
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Does your dog attend doggie daycare?If so, how many times a week and for how long each day?
36
Why are you seeking dog training help?
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It is important during training to see how your at home training sessions go between meetings. This way I can advise on small changes or extension on your training to keep the progress moving! I require that you send one video a week for feedback.
Yes, I will send one video a week
38
I understand that the initial consultation is $85. Sessions after that can be purchased individually at $65 each ORYou can purchase packages: 4 for $240 or 8 for $440Packages must be used within 6 months and are non-refundable.
Yes
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