Client Intake Form Let’s work together.Please complete the Client Intake Form, and we’ll be in touch shortly. We look forward to connecting with you! Name * First Name Last Name Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country What services are you interested in? * Service/Therapy Dog Training Board and Train Programs Private Training Packages Behavioral Modification Training Programs Reinforcement and Refreshment Training Vacation and Extended Stay Boarding Other How did you hear about us? * Referral Google Instagram/ Facebook Other Your dogs: Name, Age, Breed? * Where did you get your dog? * Reputable breeder Backyard breeder Rescue Other Dog's Gender * Male Female Is your dog spayed or neutered?(Y or N) * Your dog's approximate weight in pounds. (e.g. 75lbs) * Any medical history? (e.g. surgeries, accidents, allergies) * Is your dog kennel/crate trained * Yes No Working on it Only at night Do you take your dog to dog parks? * Yes No Do you take your dog to Daycare? * Yes, regularly No Occasionally Do you allow your dog to greet people or other dogs on-leash? * Yes No Do you allow your dog to sleep in your bed or come up on the furniture regularly? * Yes, on the bed Yes, on the furniture Yes, they go wherever they want They only come up when invited No Does your dog come when called? * Yes No Sometimes Does your dog pull on-leash? * Yes No What type of collar, leash or harness do you currently use? * What type of home do you live in? * Single family home Apartment complex Condo Townhouse Single level home 2-3 story home How many people live in your home * Enter 1-20 including yourself. Please specify how many other animals/ pets live in your home. Include types * Cats, chickens, cows? Any other dogs in your home? Are they well trained? * Provide age, breed and current level of training. If your dog has any previous training history please provide details here: Does your dog have any bite history with any dogs, humans or other animals? Are you concerned for your safety or others? If yes, please describe Please describe your training goals and any current concerns that you currently have: * The more details the better! Behavioral issues and concerns: Please mark all that apply: Leash pulling Leash reactivity Resource guarding( toys, food, people) Separation Anxiety Not kennel/crate trained Not potty trained Nipping or mouthing Jumping Marking(peeing) Destructive chewing Mounting people/dogs Excessive barking Excessive whining Counter surfing Not eating regularly Digging No table manners Aggression towards humans/dogs/other Nervous and stresses easily Shy/ timid Fearful of people Fearful of new environments Fearful of objects Scared of noises Crate nonsense (howling, scratching, etc) Difficult being handled by others (vet, groomers, etc) Car anxiety Other Thank you! We look forward to connecting with you!
