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Intake Form: Training Sessions
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Name
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Your answer
Email
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Your answer
Phone
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Your answer
Address
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Your answer
Instagram handle, if applicable
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Your answer
Which service offering are you interested in?
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The Liam (new clients)
The Ruby (new clients)
The Maude (returning clients only)
Refresh lesson (returning clients only)
Hybrid Program (stay and train + private lesson package)
Other
Dog Name
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Your answer
Dog Age
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Your answer
Dog Sex
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Your answer
Dog Weight
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Your answer
Dog Breed
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Your answer
How long have you and your dog lived together?
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Your answer
List any other children or pets in the household, ages for all and dog breeds, if known.
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Your answer
Describe problem or nuisance behaviors you'd like to change.
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Your answer
What have you tried in the past? Did it work? Not work?
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Your answer
What tools do you currently use?
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Harness
Flexileash
Gentle leader
Prong collar
Ecollar
Sliplead
Flat buckle collar
Martingale
Other:
Required
Please list your top 3 training goals.
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Your answer
How can reaching your goals impact your life? For you and your dog?
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Your answer
How willing and open are you to make change?
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Not very willing or open
1
2
3
4
5
6
7
8
9
10
Highly motivated and ready to implement change to see change, even if it's tough for me.
What barriers do you perceive that would impact your being able to reach your goals?
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Your answer
What strengths do you have that would support reaching your goals?
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Your answer
Tell me about your dog's daily routine/schedule, from wake up to bedtime.
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Your answer
Do you currently sleep with your dog?
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Yes, and I'm willing to stop
Yes, and I'm NOT willing to stop
No, Fido free roams at night
No, Fido is crated at night
Does your dog use a crate at night?
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Yes
No
Does your dog use a crate when you are gone from the house (at work, running errands, etc.)?
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Yes
No
Is your dog allowed on furniture?
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Yes, freely
Yes, by invitation only
No
Please choose which most accurately describes your dog's meal times.
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Free graze, left out all day
Scheduled, eat in crate
Scheduled, eat out of crate
Does your dog go to daycare?
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Yes
No
Does your dog go to public dog parks?
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Yes
No
What does your dog do when he/she sees or meets a new person?
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Your answer
Has your dog ever bitten, attempted to bite, nipped at, or been at risk of biting a human?
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Yes
No
If yes, please describe.
Your answer
What does your dog do when he/she sees another dog? Is this different on vs off leash?
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Your answer
Any other information that you'd like for me to know?
Your answer
Questions for me?
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Your answer
If referred, please let me know by whom so I can send them a thank you!
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Your answer
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