New Student Evaluation Form

The Classy Canine

Intake Form
Owner Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Preferred Contact Method for Evaluation Follow-Up*

TextEmail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact:*

First NameLast Name
Emergency Contact Phone Number:*
Please enter a valid phone number.
What is your dog's name, age, breed, and date of birth?*
Is your dog spayed or neutered?*

YesNo
Which veterinary clinic sees your pet for routine vaccinations?*
List any medications or supplements and the dose/frequency your pet is taking. Include flea and heartworm preventives.*
List the brand of food, feeding amount and frequency that you feed your dog.*
Does your dog have any food or environmental allergies?*
What are your reasons for contacting a trainer? Please elaborate on the challenges you are facing and the behaviors you want help with.*
What are your primary goals? Please elaborate on what you would like to achieve with your dog through training. *
Which services would you like to learn more about? Check all that apply.

Private LessonsGroup LessonsBoard & TrainDay TrainingBoarding
Select the level of obedience you wish to achieve.*

On-Leash Home Obedience - around your home and on walks around the neighborhood.On-Leash Public Obedience - pet friendly venues such as parks, hardware stores, pet stores, patios, etc.Off-Leash Obedience - Trained like the trainer's dogs, to have reliable on and off-leash obedience in real-world situations.
Do you have a fenced yard?*

YesNo
How much time can you dedicate to training each day?*

0-30 minutes30-60 minutes60+ minutes
Where did you get your dog and how old was your dog when you got them? *
Do you have any other pets in the home? Elaborate on their name, age, and breed. *
Do you have kids in the home? Please list their ages.*
Where does your dog sleep?*
Where is your dog when left unsupervised?*
Is your dog housebroken?*

YesNo
Is your dog kennel trained? How many hours does your dog spend in their kennel each day?*

Not Kennel TrainedKennel TrainedLess Than 4 Hours4-8 Hours8+ Hours
How frequently do you walk your dog?*

Every day1-2 x Week3-6 x WeekNeverOccasionally
What kind of leash and collar do you use on walks? Check all that apply.*

Nylon or Leather LeashBungee LeashFlexi LeashFlat CollarSlip Leash/Slip CollarBody HarnessHead HalterProng CollarMartingale or Slip Collar
Check all that your dog is friendly with. Leave blank if unknown.

MenWomenKidsOther DogsCatsLivestockSmall Pets (Rabbits, Guinea Pigs, etc.)
Check all that your dog is uncomfortable around, afraid of, or reactive to. Check if unknown.

MenWomenKidsOther DogsCatsLivestockSmall Pets (Rabbits, Guinea Pigs, etc.)
Has your dog ever bitten a person or another animal?*

YesNo
If yes, please share any additional context that may help us better understand the situation.
Has your dog ever tried to guard people, food, chews, toys, water, or other resources?*

YesNo
Is your dog comfortable being handled and tolerant of grooming and exams?*

YesWe need to work on it
Is there anything else you think the trainer should know about your lifestyle, your dog's behavior, or any other concerns you have?
We look forward to working with you and your pup! What is your preferred payment method?*

VenmoPayPalApple PayZelleCredit/Debit Card
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The Classy Canine