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Pet Training Application
Contact Information
What is your full name? *
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What is your gender? *
What is your street address? *
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What is your State, City and Zip Code? *
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What is your email address? *
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What is your cell phone number? *
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What is your home phone number?
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Parental consent (if a minor)
Parent name
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I/ we approve
Parent email address:
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What is your cell phone number?
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What is your home phone number?
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About Your Dog
What is your dog's name? *
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What is the gender of the dog? *
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Is your pet spayed or neutered? *
What breed is your dog?
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How old is your dog? *
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What is your pet's current level of training? *
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Has your dog passed the Canine Good Citizen Test (CGC)? *
Is your dog current on all vaccinations? (Provide a copy veterinary records) *
What is your veterinarian's name and number? *
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Does your dog have a bite record? *
Do you always carry and use clean-up bags and materials when you take your dog out in public?
Owner Activity
Rate and comment on each of the following, scoring 1 as terrible and 5 as excellent. Add comments as you feel necessary.
How well does your dog walk on a leash? *
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How often does your dog get groomed? *
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How would you evaluate your dog's weight/diet? *
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When you train your dog, how would you evaluate it? *
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How well does your dog behave at home? *
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How well does your dog react to all family members? *
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How often does your dog alert bark? *
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How well does your dog come when called? *
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Dog digs, jumps fences or likes to escape *
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How well is your dog potty trained? *
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How well is your dog crate trained? *
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How well does your dog sleep through the night? *
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How does your dog react to distractions? *
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How does your dog react to loud noises? *
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How well does your dog listen when told to leave stuff on the ground? *
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How often does your dog destroy furniture? *
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How well does your dog accept a friendly stranger? *
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How well does your dog act around children? *
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How well does your dog act around other dogs? *
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How well does your dog accept petting? *
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How often does your dog show aggression towards people? *
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How often does your dog show aggression towards other dogs? *
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How well does your dog walk on a loose leash? *
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How well does your dog sit on command? *
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How well does your dog lie down on command? *
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How well does your dog stay in place? *
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How well does your dog listen and come when off leash? *
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How does your dog walk on a leash with a stranger? *
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How does your dog react when you take toys/treats away? *
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Basic Policy & Procedures
DRUG AND ALCOHOL: No illegal drugs are permitted on the property, nor shall those under the influence be allowed to remain on the premises. We reserve the right to remove and ban any person violating this policy. Alcohol, unless served by Pawsitive Action for some event, may not be carried on one’s body, nor consumed on site. No excess of drinking or drunkenness will be tolerated on the premises. Please respect the fact that Pawsitive Action is a family-friendly environment.
Referral
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Electronic signature and date *
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