Rise Dog Training Intake Form
Please fill out the form below to the best of your ability.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
How did you hear about us?
*
Please Select
Social Media
Friend/Family
Other
Please Specify
*
What is your preferred availability for a consultation? (Select all that apply)
Weekday evenings
Weekday daytime
Weekends
Anytime
Emergency Contact (Name, Phone number)
*
Does your emergency contact have permission to make medical decisions if you cannot be reached?
*
Yes
No
Dog's Name
*
Dog's Age
*
Dog's Breed
*
Dog's Sex
*
Spayed Female
Intact Female
Neutered Male
Intact Male
Where did you get your dog? (Breeders name, rescue name, etc)
*
Any medical issues or allergies I should know about? (Sensitive skin, chicken allergy, recent surgery, etc.)
*
How much light exercise does your dog get regularly? (Leash walks)
*
1- 3 hours a week
3-5 hours a week
5-7 hours a week
7+ hours a week
Rarely do they get leash walks
How much vigorous exercise does your dog get regularly? (Off leash walks/runs, sports like agility)
*
1-3 hours a week
3-5 hours a week
5-7 hours a week
7+ hours a week
Rarely do they get off leash walks/runs
Do you play with your dog? (Fetch, tug-of-war, wrestling, etc.)
*
Yes, all the time
Yes, sometimes
Rarely
No
My dog doesn't play or doesn't like toys
Does your dog display any of the following behaviours? (Select all that apply)
*
Growling, lunging or barking at dogs
Growling, lunging or barking at people
Barking out the window
Inability to settle in the house
Pulling on leash
Barking excessively when left alone
Jumping on people
Anxious in the car
Resource guarding from people
Resource guarding from dogs
Runs away/ doesn't respond to me if off leash
None of the above
Other
What causes your dog stress?
Crates
Car rides
Rain
New environments
Busy environments
Strangers
New Dogs
Loud noises
Thunder
None of the above
Other
Has your dog ever bitten, snapped or growled at a person?
*
Yes
No
Has your dog ever bitten another dog?
*
Yes
No
Have you done previous training?
*
Is your dog crate trained?
*
Yes
No
When do you use the crate? (Select all that apply)
At night
When we aren't home
During the day sometimes even if we are home
We don't use it on a regular basis anymore
Do you take your dog off leash?
*
Yes
No
Yes, only in fenced areas
Where do you take your dog off leash?
*
Fenced in dog park
Off leash dog friendly trails (Bruce pit, Conroy pit, etc.)
Private fields/fenced in areas
None of the above
What goals do you have for your dog? (Select all that apply)
*
Off leash recall
Settle in new places/patios
Walk with a loose leash
Settle in the house when guests come over
Stop reactivity to dogs and/or people
Trust your dog around dogs and/or people
Other
Have you previously or currently use any of the following tools with your dog? (Select all that apply)
*
Prong collar
Ecollar
Bark collar
Invisible Fence
Choke collar
No pull harness
Halti/Gentle Leader
Not applicable
I am..
*
Open to using recommended training tools such as ecollars or prong collars if they will help me reach my goals with my dog.
Open to different tools, but I don't know what a prong collar or ecollar is.
Completely against the use of prong collars and ecollars.
I am interested in...
*
Private Sessions
Board and Train
Whatever is best to meet my goals
Is there anything more you want me to know?
Be as specific and detailed as you can - the more details the better.
Submit
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