Canines on Track – New Client Intake Form

New Client Intake Form

Thank you for your interest in working with us at Canines on Track. This form collects basic information about you and your dog and includes the client agreement required before participating in services. This form takes approximately 2–3 minutes to complete.
Client Information
Client Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
City/Area
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Vet Information
Vet Clinic Name*
Vet Clinic Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
I acknowledge and agree to this Emergency Care Disclaimer.

Behaviour
YesNo
If yes, please explain.
YesNo
If yes, please explain.
Yes my dog is friendly and enjoys being around other dogs.No, my dog does not enjoy being around other dogs.

Service Interest
Private TrainingPuppy Imprinting (for dogs under 6 months old)Board & Train (for dogs 6 months and older)BoardingDaycare or Day TrainingEnrichment & Adventure ServicesNot sure / need guidance
Briefly describe what brings you to Canines on Track today.*

Daycare Info
Has your dog ever attended daycare before? If so, what was their experience like?
What is your dog's playstyle with other dogs?
Does your dog exhibit any guarding behaviours? (example: toys, food, people)
LowMediumHigh

I confirm all information is accurate and agree to Canines on Track service policies and liability waiver.
Client Signature*

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Date Signed*

MonthDayYear
Date
Should be Empty:

New Client Intake Form