Capable Canine Companions Intake form
Please fill out this form as thoroughly as possible. This will allow me to have an understanding of your home life and goals, which will aid in developing a plan for you and your dog.

Following submission of your form, I will call you to further discuss training with you and your family, and schedule you for our first lesson.
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Client Information
Today's Date *
Client (your) Name *
Primary Phone Number *
Primary Email Address *
Home Address
How/where did you hear about us? *
Dog's Information
Dog's Name *
Dog's Age (or estimate) *
Dog's Breed or Mix *
Is your dog... *
Where did you get your dog? *
How long have you had your dog?
About Your Home Life
Who lives in your home? Please list the ages of everyone living in your home/interacting with your dog. *
Have you moved with your dog in the last 12 months? *
Have you added or lost any family/house members in the last 12 months? *
What other pets live in your home? Please list name, species, and age. *
Have you lost or added any pets (aside from the trainee) in the last 12 months? *
About Your Dog's Lifestyle
Where is your dog when home alone? *
Where is your dog overnight? *
Does your dog have a crate? *
If yes, does your dog like the crate?
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Where is the dog's crate located in your home?
How many hours is your dog home alone on average? *
How much, and how often , does your dog eat? *
Is food left out for your dog to eat as desired? *
What kind of toys does your dog have daily access to?
How often does your dog go on a walk? *
Who walks the dog?
How long is your average walk?
Does your dog enjoy any other type of a physical exercise?
Does your dog ever walk off leash?
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Does your dog go to dog parks?
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Does your dog pull on walks?
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If your dog pulls, what, if anything, have you done to try and change this behavior?
About Your Dog's History
Has your dog ever growled at a person or other dog (outside of play?) *
If yes, please describe what happened:
Has your dog ever bit/nipped a person or other dog? *
If yes, please describe what happened:
If your dog has nipped/bitten a person or animal, was there a tear, scratch, bruise, bleeding, or puncture? Check all that apply
Is your dog nervous/fearful of new people in your home? *
If yes, please describe what you see from your dog when people are in your home.
Please check any of the following tools that you currently use or have previously used with your dog:
About Your Goals
Please tell me 5 things you like about your dog, or that your dog does well. *
Please tell me 5 things you wish you could change about your dog. *
What made you reach out to us for training assistance? *
What would you like to accomplish through training? *
How would your ideal dog behave? *
Thank you for taking the time to fill out our registration form. These details will help us better serve you and your dog. We look forward to working with you!
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