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KG CANE CORSO INTAKE FORM
This form has been created to get to know you and your furry friend. Please complete this form as much as possible. Submitting a partially filled form will delay your processing time.
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Email
*
Your email
Owner First and Last Name:
*
Your answer
Co-Owner First and Last Name:
Your answer
Address:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Zip:
*
Your answer
Primary Contact #:
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Your answer
Secondary Contact#:
Your answer
Requested Start Date:
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MM
/
DD
/
YYYY
Referred By:
Your answer
Canine Profile
Canine's Name:
*
Your answer
Age: (YEARS) & (MONTHS)
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Your answer
Sex:
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Male
Female
Breed:
Your answer
Veterinarian Name:
*
Your answer
Veterinarian Address:
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Your answer
Medical Problems:
*
Your answer
Medications:
*
Your answer
Time/Dosage:
Your answer
Allergies:
Your answer
Last Vaccinations:
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MM
/
DD
/
YYYY
Dog Food Brand:
Your answer
# Daily Feedings:
*
Your answer
Feeding Time(s)
Your answer
Amount:
Your answer
% Time Spent Indoors:
Your answer
% Time Spent Outdoors:
Your answer
% In Crate:
Your answer
Potty Trained:
Yes
No
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Schedule:
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Has canine ever bitten or injured another animal or human being? (Y/N)
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Yes
No
If yes, please explain below:
Your answer
Additional Information:
Enrolling Training Class
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Basic Obedience Training - On Leash
Advanced Obedience Training - Off Leash
Behavior Modification Training
Potty Training
Required
Protection Training (Prerequisite Required: Advanced Obedience)
Protection Level 1
Protection Level 2
Protection Level 3
Training Expectations
Your answer
Additional Notes:
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Applicant understands there will be a non-refundable evaluation fee to give an estimate on the cost of training (evaluation fee will be applied to the training cost and will be scheduled after submission of intake form)
*
Yes
No
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