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Client Registration
Performance Canine Information Form
* Indicates required question
First and Last Name
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Your answer
Phone number
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Your answer
Email
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Your answer
Address (Street, City, Zip)
*
Your answer
Best Contact Method (Initial Contact is always phone)
Text
Email
Call
Days Available
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Dogs Name
*
Your answer
Time Owned
Your answer
Dogs Age/Weight
Your answer
Dogs Gender
*
Female
Female Spayed
Male
Male Neutered
Dogs Breed
*
Your answer
What are your main concerns?
*
Leash walking
Barking
Jumping up
Basic training
Uncontrollable barking
Happy pee (gets excited or scared and expresses bladder)
Negative Reactivity (growling, barking, unfriendly towards dogs or humans etc..)
Destructive Behaviors (Chewing, Digging)
Nipping humans (please indicate broken skin or habitual/frequent in description)
Harassing or chasing cats
Potty Training
Crate Training
Greeting guests or strangers (please indicate overly friendly or protective in description)
Pack Integration (please indicate new member or fighting between existing members in description)
Advance Training (Therapy, Service, Emotional Support, or Sports)
Other:
Required
Please elaborate on concerns..
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Your answer
Service requested (Private lessons only available for behavioral Modification)
Your answer
Comments
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