Sorry, something has gone wrong with the form.
Thank you for your interest in our training services. Please complete the following intake form so that we can reach out to you with next steps. When answering the questions, please be thoughtful, and provide detailed responses when possible. Your responses help us to ensure that we offer you the appropriate services, and are able to meet your needs.
Name
*
Email
*
Phone
*
-- Country Code --
+1 - Canada
+1 - USA
+61 - Australia
+44 - United Kingdom
Alternate Contact (spouse, partner, etc.) Name
Alternate Contact Phone #
Address
*
-- Country --
Australia
Canada
United Kingdom
USA
Please include the names and ages of any other household members, as well as their relationship to you
Please provide the name, best phone number, and relationship of your emergency contact.
*
Veterinarian
*
Veterinary Clinic/Practice Name
Veterinary Clinic/Practice Phone #
*
Pet Name
*
Birthday
*
Sex
*
-- Select One --
Male
Female
Is your pet spayed or neutered? (Select yes for vasectomies/bilaterial oophorectomy)
*
-- Select One --
No
Yes
How much does your dog weigh (lbs)?
*
Breed
*
When did you obtain your dog?
*
Where did you obtain your dog?
*
-- Select One --
Breeder
Rescue
Shelter
Pet Store
Neighbor/Friend/Family Member
Other
If you responded to the previous question with breeder, rescue group, or shelter, please share the name of your breeder or organization. Otherwise, please enter N/A.
*
Please list the other pets in your home, including species and age
Is your dog current on all necessary vaccinations? This includes Distemper and Parvo (usually included in a combo vaccine such as DLPP or DHLPP), as well as Rabies if your dog is 16+ weeks. We also strongly recommend vaccinating for Bordatella, Canine Influenza, Lyme, & Leptospirosis if requesting boarding. Note: Proof of vaccination must be provided at least 24 hours prior to services. If your dog receives additional vaccinations at any point, please log in to your portal to upload them to keep records current.
*
-- Select One --
No
Yes
Has your dog tested positive and/or been treated for parasites (hookworm, roundworm, giardia, etc.)?
*
No
Yes
Have never tested
Unsure
Which of our training services are you interested in?
*
Private Puppy Package
Private Adult/Adolescent Package
Individual Private Training Sessions
Behavior Consultation/Package
Group Classes
Other
What are your training goals? Please be as detailed as possible. For example, if you are interested in basic manners training, please list the behaviors you would like your dog to learn.
*
What training has your dog already had?
*
Group class
Private training
Board & Train
Training program with breeder
What cues does your dog already know (can respond correctly at least 80% of the time)?
*
Describe your dog's energy level.
*
Lazy/Inactive
Normal
Active
Restless/Can't Settle
Hyperactive
Which of the following apply to your dog? Select all that apply.
*
None of these apply
Jumps up on owners or strangers
Barks excessively at owner
Barks excessively at strangers or other dogs
Won't come when called
Escapes the house/yard frequently
Nips/grabs with mouth
Is possessive of toys or other items
Eliminates in the house (urine or feces)
Consumes feces (their own and/or other animals)
Consumes non-food items
Destructive (i.e. chewing, digging, etc.)
Can't be contained (i.e. crate, room, etc.)
Sound/Noise sensitive (i.e. startles easily, appears afraid in response to loud noises, afraid of thunderstorms, etc.)
Appears anxious or afraid when at home (i.e. ears back, cowering, tail tucked, shaking, retreating, hiding, etc.)
Appears anxious or afraid when in new environments
Displays compulsive behaviors (i.e. shadow chasing/jumping, tail chasing, light chasing, self-injurious grooming, etc.)
Are there behavioral issues that you would like to address (i.e. reactivity, aggression, separation anxiety, etc.)? If yes, please describe them. Otherwise, enter N/A.
*
Has your dog ever snapped at or bitten someone (does not include normal puppy mouthing/nipping)? If your dog is adopted, please include any incidents from previous homes.
*
No
Yes
If yes, please identify your dog's level of aggression for the MOST SEVERE incident (select all that apply).
*
My dog has never snapped/bitten
Growl
Snarl/Bare Teeth
Snap (bite directed at person/dog, but no contact)
Bite with skin contact, but no damage
Bite with bruising
Bite with 1-4 minor punctures
Bite with more severe damage (deep punctures/lacerations)
Multiple Bites
Bite and Hold/Shake
Other
Has your dog ever been aggressive to another dog?
*
No
Yes
If yes to the above, please describe. Otherwise, enter N/A.
*
Do you use or have you used any of the following with your dog? Select all that apply.
*
None of these
Shock collar (e-collar, e-stim, etc.)
Vibration collar
Citronella collar
Prong collar
Choke collar
Martingale collar
Flat collar
Harness
No pull harness (Easy Walk, Freedom, etc.)
Head halter (Gentle Leader, Halti, etc.)
Slip lead
Retractable leash
How do you respond when your dog does something wrong?
*
Has your dog ever had any training (formal or informal) in bite or protection work, i.e. IGP, Schutzhund, Mondio, etc.?
*
-- Select One --
No
Yes
I don't know
How did you hear about us?
*
-- Select One --
Website
Facebook
Instagram
Friend/Acquaintance
Web Search/Google
Veterinarian
Your Dog's Friend
Peaceable Paws (Pat Miller)
Certification Council for Professional Dog Trainers (CCPDT)
Fear Free Pets/Happy Homes
Referred by Another Trainer
The Laurel Independent newspaper
West Laurel Newsletter or Listserv
Other
Submit
Please enter all required fields above.
