Training Intake:
This form will help Dognamics better understand you and your dog's needs and expectations.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please Indicate when the best times are for phone calls.
Weekday Evenings
Weekday Days
Weekend Evenings
Weekend Days
I prefer email correspondence
Email
*
example@example.com
Other Members of the Household:
How did you hear about Dognamics?
*
The program you are most interested in?
Please Select
Private Sessions
Online Sessions
Board and Train
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Your Dog
Dog's Name:
*
Sex
*
Male
Female
Male (Neutered)
Female (Spayed)
Breed: (List best approximation if mix)
Age: (Best approximate if unknown)
*
Weight:
*
Color:
Where did you get your dog? (list breeder or rescue organization)
*
How long have you had your dog?
*
Are there any other animals in the house?
*
Please list species, breed, sex, age, spayed/neutered.
Please list, if any, dog walker/ dog day care company you use:
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Medical
Vet Clinic/ Current Veternarian:
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Is your dog currently on any medications?
*
Please include Flea and Heartworm Preventives.
Does your dog have any allergies?
*
Please list both food and environmental, if applicable.
Does your dog have any medical limitations or injuries?
*
Please list past injuries, things like seizures or visual/hearing impairments.
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Diet
Current type/brand of food your dog is on?
*
Describe your dogs current feeding routine?
Please note if you free freed. (as in your dog has constant access to food)
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Training
What are your training expectations?
*
Describe both long term and short term goals.
Has your dog received any previous training?
*
Private Training
Group Puppy Class
Group Obedience Class (adult)
None
Sport (nosework, barnhunt, flyball, agility, etc.)
Other
If you, and your dog, have received training, with who and what did you learn?
*
Is your dog crate trained?
Yes
No
Does your dog have issues surrounding the crate, or other confinement?
If applicable, please describe any known issues surrounding the crate or isolation.
Is your dog allowed to roam free in your home?
Yes
No
Only when I'm home.
Does your dog have free access to a yard?
Yes
No
Only when I supervise.
Dog door is accessible 24/7
Is your dog allowed on the furniture
Yes
No
When Invited
Only on certain furniture
How does your dog behave when/after you leave?
*
Note any barking, whining, spinning, expecting to be walked, or destruction.
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Describe your typical experience walking with your dog:
*
Does your dog meet other dogs on leash?
Yes
No
If yes, please describe the interaction
Do you currently walk your dog on specific equipment?
*
Prong Collar
Head Halter
Easy Walker
Harness
Regular Collar
Other
How does your do react to other animals?
*
Include any reactions to dogs, cats, squirrels, birds, etc. On leash and off leash.
Do you take your dog to fenced, off leash, dog parks?
*
Yes
No
If yes, please describe the general experience:
Do you take you dog to off leash, un-fenced, areas? (such as designated off leash hiking areas)
*
Yes
No
If yes, please describe the experience:
How does your dog react to children?
How does your dog react to strangers?
How does your dog react to people coming to your home?
*
How does your dog react to dogs just outside your home?
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Is your dog sound sensitive?
Yes
No
If yes, please descirbe:
Does your dog have any sensitive areas, to touch?
*
Yes
No
If yes, please describe:
Include anything like nail trims or reaching over there head, etc.
Has your dog ever growled, snapped, bitten or attacked around/over toys, food, furniture or other things?
*
Yes
No
If yes, please describe the indecent/s:
Please include incidents involving protecting people, if applicable.
Has your dog ever growled at another dog, human, or object?
*
Yes
No
If yes, please describe:
Has your dog ever bitten a dog?
*
Yes
No
If yes, please describe the incident:
Has your dog ever bitten an adult?
*
Yes
No
If yes, please describe the incident:
Has your dog ever bitten a child/infant?
*
Yes
No
If yes, please describe the incident:
Does your dog exhibit any of the following behaviors, obsessively?
*
Barking
Digging
Chewing
Jumping on people
Mouthing
Tail Chasing
Licking (floor, self, walls, etc)
Constant Whining
Hyper focus on things like rocks or light
If yes, please describe:
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Is your dog currently on behavioral medications? (clomicalm, fluoxetine, CBD, etc.)
*
Yes
No
If yes, please describe type, dosage, and how long your dog has been on medications:
Please also describe any behavioral changes your dog has had on such medications:
Is there anything additional you'd like to address on this form, with your dog?
*
What do you feel is your dogs favorite thing or activity?
*
What would you say is you and your dogs favorite activity to do together?
*
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