New Dog Intake Form

New Dog Intake Form

Help me learn more about you and your pup so we can confirm we are a great fit.
About You
Owner Name

First NameLast Name
Email Address
example@example.com
Yes, add me to the A Girl's Leash On Life mailing list for updates, tips, and openings.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Yes, send me text messages about openings, promotions, and updates. Message and data rates may apply. Reply STOP to opt out anytime.
Is your dog's pick-up address different from your home address?
Dog Pick-Up Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Pick-up location notes (for example: office, family member's home)
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Home Access
Access Notes / Gate or Alarm Codes
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Veterinarian Name
Veterinarian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list your dog's primary vet so I can reach them quickly in an emergency.
How did you hear about A Girl's Leash On Life?
Services
Which services are you interested in?
Preferred days and times
Expected service frequency
Top training goals
About Your Dog
Dog's Name
Breed or Mix
Age (Years)
Sex
Spayed or Neutered?
Weight (lbs)
Color or Markings
Microchipped?
How Long Have You Had the Dog?
Where Did the Dog Come From?
Clear Photo of the Dog

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Dog's Personality, Favorite Things, and What Makes Them Happy
Behavior & Energy
Energy level

1

2

3

4

5

1 is Couch potato, 5 is Never stops
Leash walking style
Walking equipment used
Behavior with other dogs
Behavior with new people
Behavior with children
Behavior with cats or small animals
Behaviors or quirks
Has the dog ever bitten or injured a person or another animal?
If yes, what happened, when, and what was the outcome?
Triggers or fears
Commands or cues the dog knows
Car Rides & Transport
How does your dog do in the car?
Does your dog need help getting in or out of a vehicle?
Is your dog crate trained?
Car ride notes
Health, Meds & Routine
Does your dog take any medications?
Medication Name
Allergies (food or environmental)
Medical conditions, injuries, or physical limitations
Feeding routine: food brand, amount per meal, and meal times
Are treats OK? Any treats to avoid?
Daily routine: wake-up time, potty schedule, walk times, bedtime
Potty cue word or habits
Dose
Time(s) Given
How is the medication given?
Vaccines & Prevention
Proof from your veterinarian (records or a vet portal screenshot) is required before the first service. Vaccine requirements depend on the services selected.
Core vaccines required for all services
Required for Solo Dog Walk or Group Dog Walk
Required for Group Dog Walk
Assumption of risk and release of liability

I understand that working with dogs involves inherent risks, including bites, scratches, illness, injury, escape, fights with other animals, and reactions to unpredictable events, even when every reasonable precaution is taken. I voluntarily assume these risks. To the fullest extent permitted by Pennsylvania law, I release A Girl's Leash On Life, LLC and its owner from claims arising from services, except for gross negligence or willful misconduct. I agree to be responsible for, and to indemnify A Girl's Leash On Life, LLC against, any injury or damage my dog causes to any person, animal, or property, including any history of aggression I did not disclose.
Training Terms
No guarantee of results: Dog behavior is influenced by genetics, health, environment, and owner follow-through. A Girl's Leash On Life does not guarantee any specific training outcome.
Owner homework: Training results depend on consistent practice at home. I agree to practice the homework provided between sessions and to follow the management plan, and I understand progress may stall without it.
Force-free methods: A Girl's Leash On Life uses positive reinforcement, force-free training methods only. Prong, choke, shock, or other aversive tools will not be used during services, and I will not ask that they be used.
Serious aggression referral: If my dog shows serious aggression, fear, or behavior concerns beyond the scope of training, A Girl's Leash On Life may pause or end services and refer me to my veterinarian, a veterinary behaviorist, or a certified behavior consultant.
Excluded training: A Girl's Leash On Life does not train service dogs, guard dogs, protection dogs, attack dogs, police dogs, or dogs for sport or competition, and does not provide those services.
Meet and greet evaluation
I understand I will sign the full A Girl's Leash On Life Client Service Agreement and upload vaccine records before my first service.
Upload vaccine records

*You can provide these at a later time if you don't have them handy.
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Flea/tick prevention product used
Is your dog on heartworm prevention?
Is your puppy under 18 weeks old?
Agreements
In an emergency, if I cannot be reached, I authorize A Girl's Leash On Life, LLC to transport my dog to my veterinarian or the nearest emergency veterinary hospital and to approve treatment up to $750 without reaching me. I agree to pay all veterinary costs and related transport costs. Treatment above $750 requires my approval or my emergency contact's approval, unless the veterinarian considers it necessary to save my dog's life.
Preferred emergency veterinarian (if different from regular vet)
Photo and video release
Cancellation and payment policy

I understand: (a) payment is due at booking or before the service, and training packages are prepaid and non-refundable once a session has been delivered; (b) cancellations with less than 24 hours notice are charged 50% of the service; (c) same-day cancellations, no-shows, and lockouts (when the dog or home cannot be accessed as arranged) are charged 100%; (d) unpaid balances over 7 days past due incur a $15 late fee and services pause until paid; (e) returned or declined payments incur a $25 fee; (f) rates may change with 30 days written notice.
I confirm the information above is accurate, including any history of biting, reactivity, or health concerns.
Anything else you'd like me to know
E-signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

New Dog Intake Form

About You

Services

About Your Dog

Behavior & Energy

Car Rides & Transport

Health, Meds & Routine

Vaccines & Prevention

Training Terms

Agreements