Services
Online Training
Hybrid Training
Private Lessons
Group Classes
Service Area
Lafayette
Enrollment Form
Client Policies
Meet the Trainer
Contact
337-541-0244
Training Form
Step 1 of 9 - Pet Parent Information
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Pet Parent Information
Pet Parent Name
*
First
Last
Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Cell Phone
*
Home Phone
Work Phone
Email
*
Occupation
Type of Home
*
Select
Home
Townhouse
Appartment
Other
Fenced in Yard
*
Select
Privacy Fence
Hurricane Fence
Invisible Fence
None
Dog Information
Dog Information
*
Click the plus sign to add multiple dogs who will be included in training.
Name
Breed
DOB/Age
Sex
Spayed/Neutered
Where did you get your dog?
*
Select
Breeder
Individual
Rescue Group
Shelter
Pet Store
Family/Friend
Stray
Other
How long have you had your dog?
*
List any physical/breed characteristics that contributed to your choice for your current dog.
*
List three things you like about your dog
*
Click the plus sign to add more.
List three things you dislike about your dog
Click the plus sign to add more.
Type of identification
*
Select
Microchip
Rabies/License Tag
Name Tag
Tattoo
Other
Was there previous owners?
*
Select
Yes
No
Why was the dog given up?
*
Why did you get your dog(s)?
*
Check all that apply.
Companionship
For the kids
Protection
To Breed
Received as a Gift
Sports/Competition Work
Assistance/Service/Therapy/Emotional Support
Companion for other dog
Other
What sports/competition work do you plan to accomplish with your dog(s)?
*
Have you owned a dog in the past?
*
Select
Yes
No
What breed of dog have you previously owned?
*
Veterinary Information
Veterinarian's Name
*
City
*
Month/Year of last visit
*
Reason for last visit to the vet
*
Date Vaccinated
*
Date Format: MM slash DD slash YYYY
Vaccines given
*
Is there any current health problems and medications?
*
Select
Yes
No
Provide information about current health conditions and medications.
*
Was there any past health conditions and treatment?
*
Select
Yes
No
Provide information about past health conditions and treatments.
*
Does your dog have any food allergies, including food allergies?
*
Select
Yes
No
Provide information your dogs allergies.
*
Has your dog ever been handled by a vet staff?
*
Select
Yes
No
Has your dog ever been muzzled?
*
Select
Yes
No
Is your dog on heartworm medication?
*
Select
Yes
No
Is your dog on flea/tick preventative?
*
Select
Yes
No
Can we contact your vet to discuss health and behavioral issues with your vet?
*
Select
Yes
No
Diet & Elimination Information
What type of food do you feed?
*
Select
Raw
Kibble
Canned
How often do you feed?
*
How much do you feed?
*
What time(s) do you feed at?
*
Does your dog finish all food given?
*
Select
Yes
No
Sometimes
How long do you leave food down for?
*
Does your dog get treats and chews?
*
Select
Yes
No
Sometimes
What type of treats/chews are given and how often?
*
List three of your dog's favorite treats.
*
Click the plus sign to add more.
Has your dog ever become possessive over food or treats?
*
Select
Yes
No
Sometimes
Provide information about your dog's possessive behavior over food/treats?
*
Be as detailed as possible
Is your dog reliably housetrained?
*
Select
Yes
No
Sometimes (Infrequent Accidents)
Is your dog crate trained?
*
Select
Yes
No
Is your dog paper/pad trained?
*
Select
Yes
No
Is your dog litter box trained?
*
Select
Yes
No
Do you have a dog door?
*
Select
Yes
No
How many times a day is the dog walked for elimination?
*
How many times a day does your dog defecate?
*
Exercise Information
What type of exercises does your dog get and how often/long are they?
*
If not receiving any exercise at this time, note “none” and the reason.
Who is typically in charge of exercising your dog?
*
If walks are provided, what walking "tools" do you use?
*
Check all that apply.
Buckle Collar
Head Halter
Body Harness
Pinch/Prong Collar
Choke Chain
4-6ft Leash
Retractable Leash
Does your dog ever become reactive to other dogs, cats, and/or people on walks?
*
Select
Yes
No
Provide information on your dog's leash reactivity on walks.
*
Be as detailed as possible.
Does your dog play with toys or play games?
Select
Yes
No
What is your dog's favorite toy/game?
*
What other activities does your dog enjoy?
*
Environment Information
List all people, including yourself, who live in your household.
*
Click on the plus sign to add in additional household members.
Name
Gender
Relationship
Age of children
Who will be responsible for practicing training exercises with the dog?
*
Who does the dog "belong" to or is it a family dog?
*
Does anyone in the household dislike the dog?
*
Select
Yes
No
Why is the dog disliked?
*
Is anyone in the household scared of the dog?
*
Select
Yes
No
Why is the dog feared?
*
Is the dog scared of anyone in the household?
*
Select
Yes
No
Why is the dog scared of household members?
*
Do you have other pets?
Click on the plus sign to add additional pets.
Animal Type
Age
Sex
If there are other pet(s) in the household, how does your dog get along with them?
*
Lifestyle Information
Where is your dog kept when you are not home?
*
Select
Indoors, not confined
Indoors, confined
Yard, not confined
Yard, confined to dog run
Yard, tied out or chained
Other
Provide information on how your dog is confined when you are not home.
*
When you are home is the dog allowed in the house?
*
Select
Yes
No
Do you want your outdoor dog to become an indoor dog?
*
Select
Yes
No
Why is your dog not allowed in the home?
*
Select
Allergies
Cleanliness
Not Potty Trained
Destructive
Preference
Other
Provide information on why your dog is not allowed in the home.
*
When you are home is your dog ever confined?
*
Select
Yes
No
How is your dog confined when you are home?
*
Select
Crate
Pen
Room
Why is your dog confined when you are home?
*
How long is the dog confined for when you are home?
*
Where does your dog sleep at night?
*
Does your dog sleep in a crate at night?
*
Select
Yes
No
How many hours a day is your dog without human companionship?
*
Training Information
Has your dog received previous training?
Check all that apply.
No
Trained Ourselves
Puppy Group Training
Basic Group Training
Intermediate Group Training
Advanced Group Training
Private Lessons
Sent to a Trainer
Did you complete the group classes?
*
Select
Yes
No
Training methods used
Check all that apply.
None
Food Treats
Verbal Praise
Verbal Corrections
Physical Corrections
Organization name or trainers name your dog previously received training from.
What commands does your dog know?
*
Check all that apply.
None
Sit
Down
Stay
Come
Walks nicely on leash
Leave It
Give
Wait
Go to your place
Quiet
Off (furniture or when jumps)
Other
List other commands your dog knows.
*
How reliable is your dog with known commands?
*
Select
100%
75%
50%
Inconsistant
What behaviors does your dog do?
*
Check all that apply.
Aggressive
Jumps on people
Mouthing/Nipping
Urinates in house
Steals food/objects/trash
Guards food/chews/toys
Play biting
Aggressive vocalization when alone
Threatening/Biting family members
Fearful
Pulls on leash
Chews on furniture/property
Urinates when excited
Darts out doors/gates
Excessive attention seeking
Stool consumption
Excessive vocalization when home
Threatening/Biting Strangers
Anxious when alone
Destructive when alone
Digs in yard
Defecates in house
Escapes from yard
Jumps on furniture
Understands but will not obey
Threatening/Growling at animals
Other
Describe your dog's aggression.
*
Be as detailed as possible.
Describe your dog's fearfulness.
*
Be as detailed as possible.
Describe your dog's other behavior not listed above.
*
Be as detailed as possible.
Describe any procedures and training equipment used to try and correct behaviors marked above.
*
Be as detailed as possible.
In order of importance, what do you need help training your dog in?
*
Has your dog ever bitten anyone?
*
Select
Yes
No
Has your dog ever bitten an animal?
*
Select
Yes
No
Provide details of your dog's bite incident(s).
*
Be as detailed as possible.
Was medical attention needed for the victim following your dog's bite incident(s)?
*
Select
Yes
No
Provide details on the medical care needed.
*
Be as detailed as possible.
What is your dog's usual reaction to someone new entering the home?
*
When was the last time someone unfamiliar entered the home?
*
Is there anything else we need to know?
*
Referral Information
How did you hear of us?
*
Select
Veterinarian
Former Client
Google Search
Advertisement
Breeder
Rescue/Shelter
Pet Related Business
Other
Name of referring individual, organization or publication
*
Services
Online Training
Hybrid Training
Private Lessons
Group Classes
Service Area
Lafayette
Enrollment Form
Client Policies
Meet the Trainer
Contact
337-541-0244
