Dog Training Application

Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number

Email

example@example.com

Other Members of the Household:

How did you hear about Dognamics?

The program I am most interested in:

Time availability for private lessons:

Saturday 1p-4p Saturday 4p-7p Weekday 9a-12p Weekday 12p-3p Weekday 3p-6p

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:

Vet Clinic/ Current Veternarian:

Phone Number

- Area Code Phone Number

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.

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)

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.)

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.

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

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?

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:

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?

Training Application:

Your Dog

Medical

Diet

Training