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New Client Intake
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Name:
Your answer
Phone:
Your answer
Email:
Your answer
Address
Your answer
How did you hear about us?
Your answer
Dog's name:
Your answer
Breed or best guess:
Your answer
Dog's age and size/weight:
Your answer
Sex, spayed/neutered?
male
female
altered/yes
altered/no
Where did you get your dog?
Breeder
Shelter/Rescue
Private adoption
Other:
Clear selection
At what age did you acquire your dog, and how long have they been with you?
Your answer
Other dogs or animals in the home?
Your answer
Any known allergies?
Your answer
When was your last vet visit/wellness check?
MM
/
DD
/
YYYY
Names and ages of family members:
Your answer
Prior training with this dog:
Your answer
What are you hoping to teach your dog?
Your answer
Are you presently struggling with unwanted behaviors?
Your answer
How does your dog respond to unknown dogs while on leash?
Your answer
How does your dog respond to unknown people that enter your home?
Your answer
Has your dog bitten another dog/animal or a person?
no
yes/animal
yes/person
Clear selection
Do you agree, during the course of our work together, to refrain from the use of any aversive training tools and methods including but not not limited to: electronic collars of any kind, prong/pinch/choke collars?
yes
no
Other:
Clear selection
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