Request for Private Lessons

Owner Information
Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Can you receive text messages at this number

Yes No
E-mail *
What is the best way to contact you?

Text Email
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How did you hear about me?
Please list the name and ages of all people living in the home
Home type

Single family Townhouse Apartment
Fence type

Fully enclosed physical fence Partially enclosed physical fence Invisible fence No fence
What days and times are most convenient for you for private lessons? *
Dog #1
Dog's Name *
Where did you get your dog? Please include NAME of rescue, shelter or breeder if applicable *
Why did you obtain this dog? (Companionship, watchdog, sport competition, playmate for current dog, etc) *
Breed *
Age *
How Old Was The Dog When You Acquired It? *
Gender *

Male Female Neutered Male Spayed Female
Dogs Weight (approximate)
Is your dog friendly with?

Men Women Children Other dogs
Where Does Your Dog Sleep At Night?
Is Your Dog House Trained?
Does your dog attend doggie day care? If yes, please tell us which one.
Dog #2 (Only if this dog needs training as well)
Dog's Name
Where did you get your dog? Please include NAME of rescue, shelter or breeder if applicable
Why did you obtain this dog? (Companionship, watchdog, sport competition, playmate for current dog, etc)
Breed
Age
How Old Was The Dog When You Acquired It?
Gender

Male Female Neutered Male Spayed Female
Dogs Weight
Is your dog friendly with?

Men Women Children Other dogs
Where Does Your Dog Sleep At Night?
Is Your Dog House Trained?
Does your dog attend doggie day care? If yes, please tell us which one.
Please list the name and ages of all other dogs living in the home and indicate if they are spayed or neutered. *
Veterinary Information
Veterinarian
Veterinarian Phone number
Is Your Dog Current On All Vaccinations Including Rabies? *

Yes No
Vaccination Dates Dog # 1
Rabies: *
DHLP: *
Please List All Medications Your Dog Is Currently Taking. Please Include Heartworm, Flea and Tick Medications, etc *
Please List Any Medical Problems Your Dog Has Had: *
Vaccination Dates Dog # 2
Rabies:
DHLP:
Please List All Medications Your Dog Is Currently Taking. Please Include Heartworm, Flea and Tick Medications, etc
Please List Any Medical Problems Your Dog Has Had:
Behavior Information Dog # 1
What training has your dog had, and with who? *
Which of the following tools have you tried with your dog *

Head collar No Pull Harness Muzzle Choke Collar Prong collar Electric collar Citronella collar Spray bottle
Behavior Problems: *

Jumping Up Chewing Digging Barking Howling Whining Urinating Stool Eating Tail Biting Tail Chasing Staring Aggression toward people Aggression toward other dogs Separation Anxiety
Describe Unwanted Behavior In Greater Detail: *
Do You Use A Crate? *

Yes No
Does Your Dog Like The Crate? *

Yes No
Is Anyone In Your Family Afraid Of Your Dog? If So, Please Describe: *
Has Your Dog Ever Bitten A Person? *

Yes No
Has your dog ever bitten another dog *

Yes No
Has Your Dog Ever Been Reported To Animal Control For Biting? *

Yes No
Behavior Information Dog # 2
What training has your dog had, and with who?
Which of the following tools have you tried with your dog

Head collar No Pull Harness Muzzle Choke Collar Prong collar Electric collar Citronella collar Spray bottle
Behavior Problems:

Jumping Up Chewing Digging Barking Howling Whining Urinating Stool Eating Tail Biting Tail Chasing Staring Aggression toward people Aggression toward other dogs Separation Anxiety
Describe Unwanted Behavior In Greater Detail:
Do You Use A Crate?

Yes No
Does Your Dog Like The Crate?

Yes No
Is Anyone In Your Family Afraid Of Your Dog? If So, Please Describe:
Has Your Dog Ever Bitten A Person?

Yes No
Has your dog ever bitten another dog

Yes No
Has Your Dog Ever Been Reported To Animal Control For Biting?

Yes No
Payment is required in advance for all services.
- Bookings will be held for 24 hours. If payment is not recieved within 24 hours, booking may be forfeited
- A travel fee will be added for destinations over 30 minutes travel time
- All payments are final and non refundable
It is the clients responsibility to contact House of Klein dog training if a training session will need to be cancelled or rescheduled under the following terms.
- Cancellations received 72 hours prior to scheduled appointment will be accepted without penalty.
- Cancellations received less than 72 hours prior to scheduled appointment will be subject to $35 rescheduling fee
- Cancellations recieved less than 24 hours prior to scheduled appointment or no shows will result in forfeiture of that session, with no refund.
Waiver

House of Klein Dog Training will endeavor to create as safe an environment as possible for the training of my dog and will offer only sound, safe and responsible training and training instruction. I have been told by House of Klein Dog Training, and understand the inherent risk of owning a dog. Including but not limited to the risk of dog bites to myself or others. I am and will remain responsible for the actions of my dog at all times. I agree to indemnify, and hold harmless House of Klein Dog Training of any and all claims of injury, expense, costs, or damages caused by my dog.

I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service.

I understand that success in training depends on my continued participation. I agree to train my dog 7-14 times a week for 10-15 minutes each session.
By Clicking The Submit Button You Agree To The Above Terms

We will contact you within 24 hours
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