Stands Alone Canine Solutions, LLC Board & Train Intake Form
14381 Highway 71 Savannah, MO 64485
Owner's Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Emergency Contact: Please list someone other than yourself in case we can't reach owner
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Dog Information
Dog's Name:
*
Dog's Breed:
*
Dog's coat color:
*
Dog's Age:
*
Please list all other animals living in the household: If none, please put N/A
*
How many cups do you feed your dog?
*
Cups
Breakfast
0
1
2
3
4
Lunch
0
1
2
3
4
Dinner
0
1
2
3
4
Other food notes:
Back
Next
General Information
Please answer all questions to the best of your knowledge. The more we know about your dog the better we can train and build relationship.
Is your dog spayed/neutered? If your female is not altered, we will not intake the dog until the heat process is over.
*
Yes
No
Where did you get your dog from?
*
Breeder
Shelter
Friend/Family
Rescue
Does your dog have a history of biting people or other animals? Please be honest because it is needed to ensure safety to our trainers, itself, and other dogs.
*
Yes
No
Unsure
If yes, please be as detailed as possible. Think of the situation. What lead up to it, what was the person doing or animal that led to the bitting, what was your reaction, who all was involved when it happened, was the dog guarding something or someone?
The more detail, the better. This will help our trainers know how to help much better than being blindsided and diagnosing the real issue with aggression.
Is your dog potty trained?
*
Yes
No
Working on it
Has your dog been through a board & train program before? Y/N if yes, please list the date and how long they stayed.
*
Does your dog show any of the following resource guarding: Mark all that apply
*
Toys
Food
People
Places
Unknown
N/A
Is your dog kennel trained?
*
Yes
No
Please list any medical or special needs issues we need to be aware of. If none, type N/A
*
Does your dog take any medications on a daily basis? If yes, please provide information (name of medication, how often, and typical or oral) if none, type N/A
*
Please provide any other information you wish our trainers to know about your dog. The more we know about your dog the better we can train them. (Not required but helpful).
Back
Next
Other Information
Vets Name:
*
First Name
Last Name
Vet's Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vet's Phone Number:
*
Please enter a valid phone number.
Please upload up-to-date vaccines: Dog's will not be able to Board & Train until vaccines are updated
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please choose your top 5 priority goals. These are the areas that are most important to you and what we will focus on the most with your dog.
*
sit
down
stay
come
heel
place
human socialization
dog socialization
jumping
leashing pulling/manners
door manners (bolting)
barking
mouthing/nipping
potty training
counter surfing
car unloading & loading
Other
If other, please list
Please choose 5 secondary goals that we can work on. These are areas that are less important to you, but still need some work. Depending on how well your dog responds to the training for the priority goals you chose above, we may have time to address these secondary concerns.
sit
down
stay
come
heel
place
human socialization
dog socialization
jumping
leashing pulling/manners
door manners (bolting)
barking
mouthing/nipping
potty training
counter surfing
car loading & unloading
Back
Next
Are you okay with using tools such as a prong collar or an e-collar? Yes or No?
*
This could be used for things like off-leash work, behavior modification, leash manners, and more.
How did you hear about us?
Internet Search
Social Media
Family or Friend
Commercial
Terms & Conditions
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: