Training & Behaviour Services Booking Form
About Yourself and Your Family
Name
*
Address
*
Street Address
Street Address Line 2
City
County
Postal Code
Phone Number
*
Email
*
example@example.com
How many people in your household [Please specify the age if children]?
*
How many pets in your household?
*
Are you happy for us to take pictures of you and your pet during the course and post them on our Social Media accounts & Website?
Yes
No
Could you please provide an Emergency Contact? [Must be different from the person booking]:
*
First Name
Last Name
Emergency Person Phone Contact
*
Your Pet
Name
*
Breed [if known]
Date of Birth
*
/
Day
/
Month
Year
Date Picker Icon
Sex
*
Weight in KG [Approx.]
Where was it adopted from [Breeder, House litter, etc]?
*
Why did you adopt this specific Pet?
*
Age when you took them home
*
What kind of diet are they on? [Ex Kibble, BARF, etc]
*
Describe your dog’s temperament in 1 word
Vet Practice & Health
Practice Name & Branch
*
When was the last vet visit?
Is your pet up to date with the vaccination plan?
*
Yes
No
Any Medical issues, past or present?
*
Any known allergies?
*
Let's Talk Behaviour!
What is your main concern regarding your dog's behaviour?
*
How long has this behaviour occurred for?
*
Has this problem changed since it first began? If yes, how?
*
What’s your intended goal trough training/behaviour modification?
*
Have you tried to work on this behaviour previously and if so what did you do?
*
Any other issues?
*
Are you happy for us to take pictures of you and your pet during the course and post them on our Social Media accounts or Website?
*
Yes
No
How would you prefer to receive any of the information and/or training methods discussed during our session(s)
Bullet Points
Short Step by Step Instructions
Video
Infographics
Any/No Preference
We might require to contact you from time to time, for example if we need to change course or class dates/times, confirm your attendance or in the event of the training classes being cancelled due to unforeseen circumstances. Please advise your preferred contact method from the options below:
Email
Phone
Facebok PM
How did you hear about us?
Please Select
Facebook
Instagram
Flyer
Word of Mouth
Looking on the internet
Vet Referral
Council Workshop
Would you like to join our newsletter? You will receive free training tips, offers and have priority booking to future workshops!
*
Yes
No
Please confirm you have read our T&C at https://www.360pawsibilities.co.uk/terms-and-conditions/ and accept them
*
I can confirm I have read the T&C and I accept them
Please remember that there is no magic wand or quick fix as often seen online or in TV. True behaviour modification takes time and patience, but we're here to point you in the right direction.
Back
Next
Save
360 Pawsibilities© 2024
Save
Submit
Should be Empty: