The Puppy Playbook Intake Form
Handler Information
Owner’s Name
*
First Name
Last Name
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred method of contact
*
Please Select
Text
Phone Call
Email
Best time to contact you
*
Please Select
Weekday Morning
Weekday Afternoon
Weekday Evening
Weekend Morning
Weekend Afternoon
Weekend Evening
Anytime
Will there be other adults or handlers present for training?
*
Yes, another adult
Yes, a minor
Yes, adults and minors
Just me
If you answered yes to the question above please add their name(s) below and relationship to you. If they will not be present and involved in the training sessions no need to list them.
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Puppy Information
Puppy’s Name
*
Breed (please type in Mixed or Unknown if applicable)
*
How old is Puppy?
What is the sex of the puppy and is it fixed?
*
Male - Intact
Female - Intact
Male - Fixed
Female - Fixed
Where did the puppy come from?
*
Breeder
Rescue
Rehomed
Found as stray
If other, please explain below
How long have you had the puppy or when do you plan to bring Puppy home?
*
Does your Puppy have any known medical conditions that may affect training? If so, please explain.
*
Is your Puppy up to date on all age-appropriate vaccines?
*
Yes
No but will be adddressed
I will not be vaccinating
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Training Priorities
This section will help me tailor The Puppy Playbook to your specific wants and needs.
Please rank the following basic obedience skills 1-4 with 1 being most important and 4 being least important.
*
Rank the following manners in order 1-6. 1 is the most important and 6 being the least important.
*
I would like to work on crate training
*
Yes
No
Unsure
I need help with potty training
*
Yes
No
Unsure
Are there any other skills you would like to work on?
*
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Home, Routine, and Current Behavior
Who lives in the home?
*
Just me
Other Adults
Children
Cats
Other Dogs
Misc. Animals
Are there children in the home that do not live there that are (or will be) regularly around the Puppy
*
Yes
No
In the future
Unsure
If you answered yes to the question above how old and what is the ages of the child(ren)?
Does, or will, Puppy live with or regularly encounter cats, small animals, livestock, or other dogs
*
Yes, cats
Yes, small animals
Yes, livestock
Yes, other dogs
No
Unsure
What motivates your Puppy?
*
Food
Toys
Praise
Play
Unsure
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Behavior and Safety Screening
I currently do not work with complex behavioral cases, however I maybe able to refer you to other experts in the area if applicable.
Has Puppy ever growled, snapped, bitten, or attempted to bite a person or animal?
*
Yes
No
Unsure
If you answered yes above, please explain the situation below. Include what happened prior to the incident, the incident itself, and how you handled it.
Has your Puppy ever caused an injury that broke skin?
*
Yes
No
Unsure
If you answered yes above, please explain the situation below. Include what happened prior to the incident, the incident itself, and how you handled it.
Does your Puppy show intense fear, panic, freezing, lunging, or extreme distress around other people, dogs, handling, noises, or new environments?
*
Yes
No
Unsure
If you answered yes above, please explain the situation below. Include what happened prior to the incident, the incident itself, and how you handled it.
Does your Puppy guard food, toys, resting areas, or items they steal?
*
Yes
No
Unsure
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Program fit and booking follow up
How did you hear about Chaos to Confidence Dog training?
Flyer
TikTok
Referal
Facebook
Community Event
Other
The Puppy Playbook is an 8-week, owner-coaching and puppy-training program.Training is tailored to each puppy’s age, development, household, and ranked goals.Submitting this form does not reserve a training spot.Chaos to Confidence Dog Training will review your form and contact you about availability, program fit, and next steps.
*
I understand
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