14 Weeks To Adult Private In-Home (Client's)

14 Weeks to adult dog

Private In-Home (Client's)

All questions marked with a red* must be answered to submit form

Training Or Course Selected:*

LIFESTYLE

The information below helps us plan the right plan for you and your dog.

Full Name*

First NameLast Name

Address*

Street Address

Unit/Apt

CityState / Province

Postal / Zip Code

Cell Number*

Area CodePhone Number

Home Number

Area CodePhone Number

E-mail*

What is your age group?*

Would you say you are?*

ActiveSedentaryToo BusyCouch Potato

Do you have any physical or health limitations?*

Living Arrangements*

Work Arrangements*

How Did You Hear About Us?*

Adults in home? Children and ages in home? *

Have You Ever Owned A Dog?*

Have you trained a dog? Level of success?*

What Do You Hope To Accomplish In This Class or Evaluation?*

Dog's Name*

Breed, Sex, Age and weight?*

Spayed or Neutered and what age?*

Other animals in the home? If so, type, age and breed?*

Where did you acquire your dog? How old when you got the dog?*

Where does your dog/dog's sleep at night?*

1.House Trained 2. Crate Trained Explain if there is a problem?*

1. How many hours is your dog left alone during the day if you are working? 2. If left alone is your dog left in a crate and how many hours?*

1. Brand Food 2. How often do you feed your dog? 3. Free feed or scheduled?*

1.Type ofexercise your dog gets daily? 2.How often do you walk your dog? Explain *

Does your dog have any disabilities? If so please explain*

Does your dog engage in play with other dogs?*

What do you use to walk your dog? check all that apply.*

Veterinary Information

Name Veterinarian address, phone*

Current on vaccinations? Is your dog on any monthly medications?*

Any medical conditions? Explain*

Behavior Information

Any Previous Obedience Training and success level?*

What Commands Currently Work Best?*

Which Member Of The Family Has The Best Control?*

Leash trained? What type of equipment used to walk your dog?*

Any unexplained behavioral issues? If so, when did it occur?*

Dog been exposed to cats? If so, reaction ?*

How well has your dog been socialized People, places, dogs, sounds? Explain any issues. Type unknown if you do not know.*

Has your dog ever been attacked by another dog? Explain*

How Does Your Dog Respond To The Following Tasks?

Groomed? Any sensitive areas on its body? *

Does your dog like to ride in the car? Does it get car sick?*

What correction techniques have you tried with your dog and the effect it had on your dog?

Time Out*

Leash Correction*

Verbal Scolding*

Water Spray*

Other Description, If Needed:

Behavior Problems:*

Describe How Your Dog Reacts To The Following Times When Left Alone:

Unwanted behavior In greater detail. Example how long and when did it begin?*

Dog's reaction to departure during day or evening?*

Does Your Dog Exhibit Any Of The Following Behaviors, And When Does It Occur?

Cowering, ears back, tail tucked, retreat or hide? If so please explain?*

Excessive Salivating*

Pacing*

React if you grab it's collar? *

Any type of aggression, i,e fear, humans, other animals? *

Has your dog been muzzle trained? Do you feel you have had to use a muzzle for safety?*

How Does Your Dog Respond To The Following Situations?

Does your dog guard toys, chewy's, bones, food?*

When Dog Is Scolded:*

When Dog Is Pushed Off Furniture Or Bed:*

Approached While Sleeping:*

To Strangers Outside Of The House:*

To People Entering House/Yard:*

To Children Or Infants:*

To Other Dogs In Your Home or outside your home?*

Has Your Dog Ever Been Reported To Animal Control For Biting? *

YesNo

Has your dog ever bitten a human or another dog?Explain*

Please upload your puppy/dog's shot record. If you can scan to your computer. If not I will get a copy from you

Browse Files

WAIVERS ******General Policy******

1. DePaul K9 Academy will endeavor to create as safe environment as possible for the training/boarding care of the dog(s) identified as (the dog), and will offer a safe, sound and responsible training, care and post-boarding training instructions.
2. Owner agrees, however, that all animals may exhibit unpredictable behaviors and that DePaul K9 Academy will not be liable for the actions of the dog that are outside the control of DePaul K9 Academy training
3. Owner agrees that the recommendation by DePaul K9 Academy training of any product or service is NOT a guarantee of performance or Owner's satisfaction with that product or service. Owner(s)understands the training is not guaranteed when not in the prescence of DePaul K9 Academy Training. The follow-up and instruction must be done daily by the owner to ensure the re-inforcement of the work and techniques used to train the dog when dog was with trainer. Owner undertsands fully the dog may revert back to old behaviors, if owners do not change the energy and behaviors of themselves at home.
4. DePaul K9 Academy agrees to indemnify and hold Owner harmless from and against any claims of injury, expense, costs, loss of damages caused by the gross negligence or willful misconduct of DePaul K9 Academy training while the dog is in sole custody, care and control of DePaul K9 Academy training.
5. Owner fully understands the tools and techniques used to train/modify the behavior of their dog and agrees to the tools/ techniques which include leash, prong collar, bark collar, remote training collar, slip lead, Pet Convincer, muzzles, flat buckle collar, gentle lead, martingale collar.

****Payment and cancellation Policy****

Payment Policy: Payment 100% in full at time of scheduling contract for private training or your board and train.
Cancellation Policy:

1.If your dog has been put on the schedule for the one or two week board and train program and you need to cancel due to unforseen circunstances we need to be notified of the cancellation within 72 hours.

2.If you have not notified us you will be responsible for 1/2 of the consultation rate, 1/2 of the amount of the one week program or 1/2 of the two week board and train.

3. If we are notified of the cancellation refunds are not given, but we will freeze the sessions till we can reschedule your training.

4. If the client chooses to NOT continue training after receiving approximately 50% of services, a refund WILL NOT be issued.

5. If the trainer feels that the client will not listen to training advice or follow instructions, Depaul K9 Academy,LLC can at sole discretion, choose to cancel the training contract and issue a partial refund will be given minus $500.00.

AGREEMENT TO HOLD HARMLESS, WAIVER AND ASSUMPTION OF RISK

I understand that attendance of a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or my dog, because of some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care. Client understands a muzzle may be needed to prevent possible bite, if dog is deemed to have any type aggression problem or bite history.

I hereby waive and release Carol DePaul, DePaul K9 Academy hereinafter referred to as the "Training Organization", its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.

Photos/Video Release (All Clients)

I hereby assign, grant and authorize DePaul K9 Academy the right and permission to use, reproduce and distribute, sale, copyright, exhibit, broadcast and publish the photograph(s), film(s), videotape(s), audio and video recording(s), electronic representations(s) and/or sound recording(s) made of me and /or my dog(s) at any time during the training and/or boarding of my dog(s) by DePaul K9 Academy. I specifically waive any right to any compensation I may have for any of the foregoing.

By the clicking on the SUBMIT button you have, read and understand the terms and agreement stated in such contract.