Your Details
Owner Information
Full Name:
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First Name
Last Name
Phone Number:
*
Email Address:
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example@example.com
Emergency Contact Name:
*
Emergency Contact Phone:
*
How did you hear about us?:
*
Dog Information
Dog's Name:
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Breed / Mix:
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Age / Date of Birth:
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Weight:
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Is your dog desexed?
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Yes
No
Microchip Number (Optional):
Health & Vet Details
Current Vet Clinic:
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Is your dog up to date on vaccinations?
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Yes
No
Any current medical conditions, allergies, or physical limitations?
*
Is your dog currently on any flea/tick/worming medication?
*
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Service Selection
Which service are you looking to book? (Select all that apply)
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Dog Walking
Individual Training
Group Sessions
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Dog Walking
Frequency Requested:
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Daily
2-3 times/week
Weekly
Casual/As Needed
Preferred Days & Times:
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Home Access Notes: (e.g., key code, lockbox location, gate instructions)
On-Leash Behavior: How does your dog walk on a leash?
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Walks loose-leash
Pulls mildly
Pulls heavily
Lunges/Reacts
Does your dog react to any of the following while walking?
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Other dogs
Strangers
Bikes/Scooters
Loud trucks/Traffic
Other
Do we have permission to let your dog off-leash in designated secure areas once a bond is established?
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Yes
No
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Individual Training
What are the main behaviors you want to work on or address?
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Has your dog ever shown signs of fear, anxiety, or aggression? (Please describe triggers or past incidents):
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Are there other pets or children in the home? How does the dog interact with them?
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What motivates your dog the most?
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High-value treats
Toys/Fetch
Praise/Affection
Tug
Other
Have you worked with a trainer before, or what methods do you currently use?
*
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Group Sessions
How does your dog typically react when seeing or meeting new dogs in a managed environment?
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Friendly/Excited
Neutral/Ignores them
Nervous/Timid
Vocal/Reactive
Has your dog ever attended a group class or structured environment before?
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Yes
No
Other
Does your dog show any guarding behavior around food, treats, or toys?
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Yes
No
Unsure
Does your dog struggle to focus or bark excessively when other dogs are nearby working?
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Yes
No
Sometimes
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Waiver Agreement
Agreement to Terms & Conditions
*
I confirm that I have read, understood and agree to the Terms & Conditions of Service, including the applicable payment, cancellation and service policies.
Emergency Veterinary Care Authorisation
*
I authorise Exercise and Enrichment to seek emergency veterinary care for my dog if required and if I cannot be reached immediately. I understand that I am responsible for any veterinary costs incurred.
Photo & Video Consent
*
I give permission for photos and/or videos of my dog to be taken and used by Exercise and Enrichment for social media, website and other business or promotional purposes.
Owner Signature:
*
Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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