Dog Training Intake Form
Dog Owner's Full Name
*
First Name
Last Name
Street Address
*
City
*
Zip
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Dog's Name
*
Dog's Breed
*
Dog's Age
*
Weight
*
Name of Breeder, Rescue, or where your dog was acquired.
*
Date of birth (if known)
*
Approximate date acquired.
*
HEALTH INFORMATION
Copy of Veterinarian Records Required
Up to date vaccines
*
Parvo/Distemper
Rabies
Leptospirosis
Bordatella
Up to date fecal?
*
Yes
No
Negative for parasites?
*
Yes
No
Heartworm positive?
*
Yes
No
Up to date on prevention? (Flea/tick, Heartworm)
*
Yes
No (please note, training cannot be started without this)
Flea/tick, Heartworm preventative frequency.
*
Microchip number.
*
Rabies tag number.
*
Medical conditions/concerns
*
Medications (If any)
*
Food/environmental allergies?
*
Please upload your dogs current vaccine records.
*
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Please upload current prevention.
*
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Please upload most recent fecal test.
*
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Feeding
How fast does your dog complete their meal?
*
Immediately
Picks at it
Takes a while to eat
How often does your dog eat? How much food?
*
What brand of food does your dog eat?
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Any food allergies/sensitivities?
*
Are you comfortable with me giving probiotics in the event of stomach upset?
*
Yes
No
Please contact me first
Sometimes, I’ll add supplements to food to help support your dog while they’re with me, such as vertex (endurance and muscle recovery supplement) salmon oil (skin and coat supplement) electrolytes, or a vitamin supplement (nupro) to make sure they’re in top shape and recovering nicely during their stay. Is that okay?
*
Yes
No
Where does your dog typically eat their meals? (crate, kitchen, etc)
*
Crate Training
Is your dog currently crate trained?
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Yes
No
Training Goal
How often and how long is your dog crated for?
Is your dog known to be destructive in the crate?
*
Yes
Yes, but only with bedding in the crate
Yes, will break out
All of the above
No
Home Life
Has your dog ever been around other dogs?
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Yes
No
Has your dog ever been in a fight with another dog?
*
Yes (please explain)
No (put N/A in box below)
History of reactivity, anxiety, fear, aggression, etc.
*
Explain
*
Have you ever taken your dog to a dog park?
*
Yes
No
Has your dog ever been around children? If so, what ages?
*
Has your dog ever barked, lunged, bitten, or growled at a child? If so, please explain.
*
Has your dog ever been around cats?
Yes, fine with them
Yes, doesn't like them
No
Have you ever used any tools on your dog? Please select all
*
Prong Collar
Gentle Lead or similar
Ecollar, Shock Collar, Bark Collar
Electric Fence
No
Goals/Main Concerns For Training
*
Submit
Should be Empty: