~~~~ ANDREW BROOK TAILS ~~~~ Private Training Pre-Registration

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CARING, COMPASSIONATE TRAINING FOR YOU & YOUR PET.

First Name *

Last Name *

Street Address or PO Box *

Town *

State *

Zip Code *

Email Address *

Phone # *

Cell #

What is the best way to contact you? *

Select all that apply.

Phone #

Cell #

Required

How did you hear about us?

Puppy or Dog's Name *

Breed/Mix *

Age *

Birth Date

YYYY

Sex *

Dog Food Name Brand

How long have you owned your puppy/dog? *

Does your dog have any food allergies? *

Does your puppy/dog have any medical conditions? If so please explain. *

Do you or your puppy/dog have any previous obedience training? *

Please explain.

Have you ever used an ecollar or prong collar on your dog? *

Yes

Other:

Do you have:

(Check all that apply)

Invisible Fence

Fenced in yard

Overhead run

Other:

Required

How often does your puppy/dog meet or play with other dogs? *

Please explain.

Describe the reaction your puppy/dog has when a new dog approaches? *

Please explain.

How often does your dog meet new people? *

Please explain.

Describe the reaction of your puppy/dog when a new person approaches? *

Please explain.

How often do you take your dog to new locations? *

Please explain

Does your puppy/dog have any undesirable behavior? *

Please explain.

What have you done so far to correct the undesirable behavior? *

Please explain any correction and his/her reaction to the correction.

What type of private lessons are you interested in? *

Puppy Evaluation and Setup

Extensive (Full) Evaluation

Problem Evaluation

AKC Canine Good Citizen (CGC)

Therapy Dogs International (TDI) Prep Test Training

Obedience Training

Puppy/Dog Beginner Training

Other:

Required

Does your puppy/dog exhibit any of the following behaviors? *

Select all that apply.

Anxious when left alone

Jumps on people

Excessive vocalization

Pulls on leash

Destructive when alone

Understands but will not listen

Mouthing/nipping

Chews furniture/property

Stool consumption

Digs in yard

Not House trained.

Urinates when excited

Housetrained but urinates or defecates in house

Steals food/objects

Darts out of doors/gates

Escapes from yard

Jumps on furniture

Excessive attention seeking

Fearful

Aggresive

Other

Required

Does you puppy/dog bite, snap, growl or show teeth in any way in any of the situations listed below? *

Select all that apply.

Around Food

During petting or brushing

Around friends, family or relatives

When you make him move off the furniture or when he is resting or sleeping

In the car

Around children

Around the owner

When approached by strangers

When being punished

Around other dogs

When you grab him by the collar

When inside a fenced area

When you take something away from him

Around toys

Other

Required

When are you available? *

morning

early evening

both

Neither

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Is there any additional information you would like to tell me about your puppy/dog?

Submit

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