Behavior Evaluation Sign Up
Behavior Evaluations are great to help us get face to face to discuss your dogs behaviors & your goals for training. They’re a free service I offer!
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Dogs Info
Name
Breed
Age
Sex
Proposed Date for Eval {No Fri-Sun Available}
-
Month
-
Day
Year
Date
Proposed time
Hour Minutes
AM
PM
AM/PM Option
What are 3 behaviors you’re concerned with your dog?
What are your top 3 Goals with your dogs training?
Has your dog ever shown human directed aggression? (Pup nipping maybe noted, but is not considered aggressive)
Has your dog ever shown dog directed aggression?
Has your dog ever shown signs of resource guarding?
Stops eating with people or another animal pass by
Eats notably faster when people or animal passes by
Body blocks other animal from reaching owner
Body blocks other animals from certain spaces (food area, bed, crate, couch)
Growls while eating or chewing
Hard Stares at other dogs when the approach a resource (toy, bone, bed, dog bowl)
Is your dog up to date on these vaccines? Please have them up to date before coming to the evaluation
Annuals (DHLPP / 5-in-1)
Kennel cough/Bordetella
Rabies if over 6 months
Flea/Tick Prevention
Liability Release Waiver
Please read below, this is to ensure the safety of everyone when a new dog comes into the facility.
I, the owner, agree I am solely responsible for any and all acts and behaviors of my dog(s) while in the care of Creekside Canine, LLC, and as such I shall pay any and all such expenses incurred promptly. I understand that I am responsible for any harm caused by my dog(s) while attending Creekside Canine, LLC. I shall indemnify Creekside Canine,LLC against any and all claims made against, or losses or damages of any kind suffered by Creekside Canine, LLC or its members as a result of my failure to inform CreeksideCanine, LLC of any medical conditions or behavioral issues or tendencies my dog(s) may have . I agree that in bringing my dog(s) to the facility, Creekside Canine has relied on my representations that my dog(s) are in good health and that they do not pose a health or behavioral threat to people or other dogs. Should my dog(s) exhibit inappropriate behavior which is deemed to compromise their own or other dogs’ safety or that of the staff, I understand that my dog(s) will be safely confined as necessary until the owner or their authorized representative can remove the dog from the premises. I agree thatCreekside Canine, LLC will not be liable for problems, damage or injury caused by or to my dog(s). I understand that Creekside Canine, LLC is fully insured and I release Creekside Canine, LLC, Kate Dean, or any members of said Creekside Canine, LLC from any liability arising from my dog(s) attendance and participation at Creekside Canine,LLC and further agree to Indemnify Creekside Canine, LLC, Kate Dean, or any members of said Creekside Canine, LLC for claims made against them arising out of my dog(s) stay at Creekside Canine, LLC. I acknowledge that my dog(s) may be placed in a kennel for‘time outs’ for aggressive or unwanted behavior in addition to meal times and overnightsleeping.
Yes
I understand behavior evaluations & training maybe recorded & any recordings are property of Creekside Canine/Katie Beth Dean and may be used as promotions, advertising or publication.
Yes
Signature
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