Client Intake Form "*" indicates required fields Owner's Name* First Last Address Street Address City State / Province / Region ZIP / Postal Code PhoneEmail Where did you hear about us?Vet's NameVet's Phone NumberHow many adults live in the home?*Please enter a number greater than or equal to 1.How many children live in the home?*Please enter a number greater than or equal to 0.Ages of children (separate by comma)*Does anyone in the home have a disability that would require special accommodations in training? Yes No What special accommodations will you be needing?*Do you have any other pets?* Yes No Please list other pets’ names, ages, and species*Dog's Name*Dog's Breed(s)*Dog's Gender*Dog's birthdate or approximate age*Is your dog spayed/neutered?* Yes No Is your dog current on vaccinations?* Yes No What brand of dog food does your dog eat?Do you free feed (is the food left out all of the time)?Does your dog have any food allergies?* Yes No Please list your dog's food allergies here*Does your dog take any medications?* Yes No Please list your dog's medications here*Does your dog have any past injuries or current conditions?* Yes No Please list your dog's past injuries or current conditions here*Does your dog have any physical disabilities that we need to be aware of?* Yes No Please list your dog's physical disabilities here*Does your dog have any fears or phobias?* Yes No Please list your dog's fears or phobias here*Does your dog have any sensitive areas on it's body?* Yes No Please list any sensitive areas on your dog’s body here*How does your dog react to strangers?*Rate your dog’s energy level (1 being very mellow and 10 being out of control)*12345678910Does your dog show any destructive behaviors when you are not at home? Yes No Please list your dog's destructive behaviors here*Is your dog aggressive on leash?* Yes No Has your adult dog ever bitten anyone (n/a for puppies)?* Yes No Please list circumstance and severity of bite*Does your dog jump up? Yes No Does your dog bark excessively? Yes No Does your dog dig? Yes No Is your dog aggressive around food or toys?* Yes No Please list any specific behaviors or issues that you would like to work on in training*GENERAL TERMSPlease check the box to acknowledge your understanding and acceptance of the statements below* I understand and agree- I understand that the methods and techniques used by Paws Companion Dog Training are predominantly positive reinforcement and management; and that no aversive tools or methods such as prong collars, shock collars, choke chains, slip leads, intimidation, force, or pain of any kind will be used on my dog at any time during training. - I understand that my participation as the primary caregiver is required in all training, both during sessions and at home between sessions - I agree that I will not use any aversive tools or methods at any time in sessions or at home during the course of training with Paws Companion Dog Training. Furthermore I understand that the methods used during the sessions need to be consistently followed at home.PAWS COMPANION DOG TRAINING AGREEMENT TO ASSUME RISK, AND RELEASE FROM LIABILITYPlease check the box to acknowledge your understanding and acceptance of the statements below* I understand and agree- I recognize that there are inherent risks of illness or injury when training dogs - I have disclosed to Paws Companion Dog Training all known risks, dangers, and medical conditions associated with my dog(s) - I understand and agree that Paws Companion Dog Training will not be liable for damages or injuries caused to my dogs provided reasonable care and precautions are followed - I hereby release Paws Companion Dog Training of any liability of any kind arising from my dog’s attendance and participation in training - I understand and agree that in enrolling my dog in training, Paws Companion Dog Training has relied on my representation that my dog(s) is in good health and is up to date on vaccinations - Any photos or videos taken of my dog in training are property of Paws Companion Dog Training - I understand that Paws Companion Dog Training is not liable for any health issues that arise from recommendations on feeding or holistic medications and that Paws Companion Dog Training always defers to recommendations given by my vet if there is any conflict in the advice given PAWS COMPANION DOG TRAINING PACKAGES AND PAYMENT SCHEDULEPlease check the package that you choose below:* Puppy Basics I (Three one-hour sessions) $400 Puppy Basics II (Three one-hour sessions) $400 Puppy Basics Bundle (Six one-hour sessions plus training book) $750 Basic Training I (Three one-hour sessions) $400 Basic Training II (Three one-hour sessions) $400 Basic Training Bundle (Six one-hour sessions plus training book) $750 Beyond the basics (Three one-hour sessions) $400 This can only be chosen after one of the basic training bundles Intro to leash training (Three one-hour sessions) $400 Training Package Agreement* I understand and agree- I understand that all three-session packages must be completed within four weeks on my regularly scheduled day and time unless previously agreed to by both parties, or if the trainer is at fault for the cancellation. If not completed in four weeks, I forfeit any remaining sessions, and no refund will be given. - I understand that all six-session packages must be completed within eight weeks on my regularly scheduled day and time unless previously agreed to by both parties, or if the trainer is at fault for the cancellation. If not completed in eight weeks, I forfeit any remaining sessions, and no refund will be given. - I understand that payment is due at or before the first training session. Payment may be made by cash or check.CommentsThis field is for validation purposes and should be left unchanged.
