Private Lesson Questionnaire
Please fill out this questionnaire so we can better assist you!
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Email *
Owner's Name *
Referred By
Pawsitive Perspective Animal Training
Cell Phone/Work Phone *
Home Phone
Home Address *
Email *
Emergency Contact Name/Phone (here in town) *
Pets Names/Age/Breed/Sex *
Pet's Vaccinations are Current? *
Veterinarian's Name/Clinic Name /Phone Number *
Does Your pet have any Medical Conditions to be aware of, Food Allergies. Dietary Restrictions, or Special Instructions for Care? *
If so please explain
What are your pet's feeding instructions (please be specific). Include brand of food, quantity and how many times per day. What is your dogs favorite treat? *
Will your pet be on any medications during training? *
If so please include instructions for medication (please be specific). Include Name of Medication, method of administration, and how many times per day administered. *
Describe any previous training your dog may have had if any
Training Wish List: What Behaviors can we work on while your pet is in our care?
Is there anything else you would like us to know about your dog behaviorally?
What type of help are we providing? Check all that you are interested in. *
Required
Sessions must be cancelled 24 hrs. prior.We do not offer billing. Sessions will be paid in full at the time services are rendered.  All packages will be paid for at the end of first lesson. Cancellations to packages must be made within the first 3 weeks to receive a refund of any class fees either full or partial. After that point packages may be transferable to other people, may be banked for future need, may be turned into a credit towards other classes or transferable to a different dog. Refunds may take up to 4 weeks to process. *
Preferred Method of Payment:
Credit/Debit Card Number to Keep on File If you want to pay with card (will not be charged without prior authorization) or handle for VENMO
Expiration Date
Billing Zip
3 digit code from back of card
 Pawsitive Perspective will endeavor to create as safe an environment as possible for the training of my dog and will endeavor to offer only sound, safe, and responsible training  and care..  However, I recognize that Pawsitive Pespective  is not responsible for any unintentional errors, omissions, or incorrect assertions.  I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service. The acceptance of my application for training membership in this training program, I hereby agree to indemnify and hold harmless Pawsitive Perspective , its officers, directors, instructors, agents, employees and/or representatives of any and all claims, or claims by any member of my family, or accompanying guests of mine of injury, expense, costs or damages to myself, my dog or any handler sponsored by me both in this program and out of the program.  In addition, I agree that I will defend and indemnify Pawsitive Perspective and for any injury, expense, costs or damages to any dog handlers or dogs, whether sponsored by me or not, or to third parties arising out of my own actions or the actions of my dog.  I give my permission to Pawsitive Perspective to make any decisions necessary concerning the health of my dog when not in my care. I hereby authorize and consent to such medical services or care which are necessary or appropriate for my dog, including the selection of veterinary personnel and facilities and transportation or transfer of my dog to such facilities and in connection with such treatment, services and/or care, to authorize and consent in my name and on my behalf to such emergency or necessary surgery, diagnostic or corrective, as they may determine to be necessary for the life, health or well being of my dog, after reasonable consultation with duly licensed veterinarians. It is understood that reasonable effort shall be made to contact the undersigned prior to rendering treatment to my dog but that any of the above treatment will not be withheld if the undersigned cannot be reached. It is understood that I will be financially responsible for any expenses incurred.   *
Please type name as acceptance of these terms *
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