Training Class Questionnaire

TRAINING CLASS QUESTIONNAIRE
Top Notch Kennels - Modesto, CA

Thank you in advance for providing us with the following information. This will help us prepare so that we can make the best use of valuable time we have together.

Training Class Start Date:

training day date start

Client's Full Name

First NameLast Name

E-mail

Phone Number

Format: (000) 000-0000.

Veterinarian's Name:

Veterinarian's Clinic Name:

Referred by:

If you were personally referred to us, who referred you?

Dog's Name:

Approximate age or DOB:

Breed:

Gender:

Spayed/neutered how long ago?

How or where was your dog obtained?

How long have you had your dog?

How old was your dog when acquired?

Do you have any concerns about your dog’s ability to participate in group classes? Check all that apply:

Choose the words that most closely describe your dog’s behavior when meeting new people: Check all that apply.

Choose the words that most closely describe your dog’s behavior when meeting a new dog: Check all that apply.

Do you feel your dog is:

Choose which most closely describes your dog:

Does your dog ride in the car?

Choose the behaviors which most closely describes your dog when riding in the car and sees another person?

Choose the behaviors which most closely describes your dog when riding in the car and sees another dog?

Choose which best describes your dog with kids:

Describe how your dog plays with toys and family members. Check all that apply:

Is your dog sensitive to touch on any part of his/her body? If yes, please explain:

Are there any known medical issues or allergies? If so, please list:

Please list any medication your dog is currently on:

Is your dog motivated by food?

VACCINATIONS

If you have updated vaccination records, you can upload a copy of the file below, email to thepack@topnotchdogs.com, or fax it to 209.548.9379.

To attend class, your dog must be current on the following, vaccinations:
Distemper/Parvo combination
Rabies - if over 6 months of age

Puppies:
Must be participating in an on-going vaccination plan through their veterinarian.

Upload Vaccination File:

Upload a File

IMPORTANT INFORMATION – PLEASE READ COMPLETELY

Missed Classes: There are no make-up sessions if you miss a regularly scheduled class. With Instructor’s permission, you are welcome to drop into another session for a similar class if available.

Withdrawals/Refunds: If you must withdraw from a class before it begins, a tuition refund will be issued to you, less a $25 processing fee, provided such withdrawal and request for refund is made no less than 7 days prior to the start of a class. “No Shows” without notice will not be refunded. After classes have begun, tuitions will not be refunded.

Waiver, Assumption of Risk, and Agreement to Hold Harmless: I understand that participation in dog training is not without risk to myself and my dog as well as any family members or guests who might attend. I hereby waive and release Top Notch Kennels, Inc. Top Notch Dog Training, and all trainers from any and all liability of any nature, for injury or damage suffered as a result of my participation in any class or private lesson, including any damage or injury resulting from the action of any person or dog, or for any accident occurring on the premises or its surroundings. I agree to accept full responsibility for my actions, for the actions of my dog, and the actions of my family or guests.

Payment: Payment in full is required to reserve your space in class. There will be a $25 fee for any returned checks.

Thank you again for providing this information. It will help us provide you with the best possible assistance.

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