Dog Training Intake

Training Intake:

This form will help Dognamics better understand you and your dog's needs and expectations.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Weekday EveningsWeekday DaysWeekend EveningsWeekend DaysI 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?

Your Dog
Dog's Name:*
MaleFemaleMale (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:

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.

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)

YesNo
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?*
Should be Empty:

Training Intake: