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Registration Form
Name
*
First
Last
Email
*
Phone Number
*
Address (including Postal Code):
*
Dog's Name:
*
Dog's Breed:
*
Dog's Age:
*
Dog's Gender:
*
Male
Male, Neutered
Female
Female, Spayed
Please provide a description of the behaviours you are hoping to address:
*
If your dog has had previous training, please provide details: (school name or trainer's name, group classes or private training, etc.)
1. Are there other dogs living in your household?
*
Yes
No
If yes, please provide breed, age and sex.
2. Identify any training methods you use, or have used, when training your dog (check all that apply):
*
Flat collar
Clicker
Choke chain
Body harness
Gentle Leader or other head halter
Prong collar
E collar
Chain pillow
3. Has your dog ever been in a fight with another dog, or bitten (intentionally or by accident) another dog?
*
Yes
No
If yes, please provide any information you have of the dog involved (breed, age, size, etc.)
4. Has your dog ever bitten (intentionally or by accident) a person? (If no, please go on to Question #5.)
*
Yes
No
If yes, was the person involved
A male adult.
A female adult.
A male child or youth.
A female child or youth.
Can you describe the fight/bite incident including where, what time of day, and any other details you can remember including immediately preceding and immediately following the fight/bite incident.
5. Please describe your dog's feeding habits:
*
Morning only.
Evening only.
Morning and evening.
6. What is your dog's typical eating habit?
*
Eats everything right away.
Eats part of his meal and then walks away.
Usually picks at his food and then walks away.
Often - more than 50% of the time - doesn't eat anything.
Won't eat unless he's hand-fed.
7. Do you feed: (check all that apply):
Kibble
Commercial, canned wet
Raw or dehydrated
Home cooked (prepared specifically for your dog)
Human leftovers or table scraps
8. Do you have an electric fence on your property?
*
Yes
No
9. Is your dog on any regular supplements, holistic medicines or prescribed medication?
*
Thanks for registering for private training. I will be in touch within 48 hours. If you have any other information you would like to provide, please use the space below. Thanks!
Name
Submit