Training Bootcamp Consultation Request

BOOTCAMP CONSULTATION REQUEST FORM

THIS IS ONLY A REQUEST; A DOG GONE SMART REPRESENTATIVE WILL CONTACT YOU SHORTLY.
OWNER INFORMATION
Owner's Name *

First Last
(Cell Phone) *
Owner's E-mail *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How many adults over 18 live in the household? *
How many children live in the household? Please list age(s).
Do you have any other animals in the house? Please list type, sex, age, and breed.
Is this dog new to your family?

Yes No
Is this for a new puppy?

Yes No
DOG INFORMATION
Dog's Name *
Dog's Date of Birth

Month Day Year
Dog's Breed *
Dog's Color *
Gender *

Male Female Male - Neutered Female - Spayed
Desired Date to Begin Boarding

Month Day Year
Date Hour Minutes AM/PM Option
Desired Date to End Boarding

Month Day Year
Date Hour Minutes AM/PM Option
TRAINING INFORMATION
I am looking to do:

Day Care Training Board & Train Puppy Program Day Care Puppy Program Board & Train Socialization in Day Care Socialization while Boarding
What are you interested in? *

Obedience Behavioral issues Socialization
Has your dog had any prior training? *

Yes No
If yes, where has your dog done training (or with whom)?
Dog Gone Smart, Petco, Canine Company, etc.
Describe your dog's behavior toward other dogs on leash
Has your Dog Ever Played Off Leash With Other Dogs Before?

YES NO
If Above answer is Yes, please explain your dog's behavior while off leash playing with other dogs and in what settings
Please List all Types of Leashes, Collars, Harnesses you currently use with your dog *
Please List Your Training Goals For Your Dog and Prioritize What you would Like Us to Teach Them (Please understand that their length of stay will determine how much we can accomplish) *
What commands does your dog know? Please include "potty" words.
What is your dog's release word?
Free dog
MEDICAL INFORMATION
Who is your Vet? *
Does your dog have any food allergies? If yes, please list ALL FOOD allergies.
Does your dog have any medical conditions or is on any medications? If so, what is the diagnosis?
BEHAVIORAL INFORMATION
Has your dog ever bitten? If yes, please explain.
Please explain your dog's aggression, the trigger(s) if known, and the circumstances of any incidents.
If your dog is aggressive, who is your dog aggressive towards? Select all that apply.

People Dogs
How is your dog in a crate?
Anything else we should know about your dog?
DOG GONE SMART

15 Cross Street, Norwalk, CT 06851

Phone 203-838-7729

Fax 203-838-7763
Should be Empty:

BOOTCAMP CONSULTATION REQUEST FORM

OWNER INFORMATION

DOG INFORMATION

TRAINING INFORMATION

MEDICAL INFORMATION

BEHAVIORAL INFORMATION