Owner Information:

    Note: ALL FIELDS ARE REQUIRED FOR SUBMISSION

    Name

    Address

    City

    State

    Zip

    Email address

    Cell Phone

    Home/Work Phone

    Communication Preference

    How did you hear about us?

    If you were referred by a Vet, vet office or Ruff House client please tell us their name we can thank them!

    What Services Are You Interested In?
    Group ClassesPrivate TrainingAdd Homeschool Extensive Program (HEP)

    Emergency Contact Information (if you're unavailable):

    Emergency Contact Name (Authorized to pick up dog)

    Emergency Contact Phone

    Dog Information:

    Name

    Sex of dog
    FemaleMale

    Age of dog

    Weight of dog

    Breed of dog

    Vaccination Due Dates

    Spayed/Neutered
    YesNo

    Where did you get your dog?

    Name of the Shelter/Rescue/Breeder/Pet Store/Other where you got your dog?

    How long have you had your dog?

    Has your dog ever been around other dogs?

    What is your dog's personality?

    Feeding & Medication:

    What brand of food do you feed your dog?

    Are you willing to change brands of food?
    YesNo

    Amount of food given per meal

    Feeding frequency

    Name(s) of any medication

    List any/all of your dog's chronic health issues, allergies or medical concerns

    Veterinary Information:

    Name of vet clinic

    Vet's name

    Dog's Current Exercise Regiment:

    Exercise Routine/Schedule

    Exercise Duration/Distance

    What type of leash and collar do you use for walks?

    On walks, does your dog....
    PullLungeZig-ZagMarkBarkWhineWalk Ahead

    Tell Us About Your Home:

    How many other people live in your home?

    How many of those people are children?

    What are the ages of the children?

    Are there other animals in your home?

    Dog(s)/Cat(s), Breed(s) & Age(s)

    Dog's Behavior/History:

    Where does your dog sleep?

    Is dog allowed to freely roam the entire house?

    Is dog completely house-trained?

    Is dog crate trained?

    What is your dog's attitude towards the crate?

    Have you boarded your dog before & how often?

    Has your dog been to doggie daycare before & how often?

    Has you dog attempted to jump/climb/dig under/escape from yard?

    Does your dog have any fears?
    Thunder-LightningSirensFireworksLoud TrucksMotorcyclesNone

    List any specific circumstances that incite fear in them

    Does your dog have separation anxiety?
    YesNo

    If so, please describe

    Does your dog excitement/nervous/submissive pee?
    YesNo

    When did this start?

    Aggressive/Negative/Guarding Behaviors:

    With humans?
    YesNoUnknown

    With children?
    YesNoUnknown

    With cars?
    YesNoUnknown

    With other dogs?
    YesNoUnknown

    With cats?
    YesNoUnknown

    With small animals?
    YesNoUnknown

    During feeding?
    YesNoUnknown

    While playing with a toy?
    YesNoUnknown

    While chewing a bone?
    YesNoUnknown

    If answer is Yes to any of the above, please list the details here

    Training Information:

    What commands does your dog respond to?

    What results or experiences good or bad, do you have from past formal training?

    Is your dog food motivated?
    YesNo

    Is your toy motivated?
    YesNo

    What equipment do you use during training eg: harness, prong collar, gentle leader, or other?

    Additional Important Information:

    Has your dog ever nipped, bitten or scratched at a dog or person and drawn blood?
    YesNo

    If so, please explain the circumstances

    Has your dog ever been medicated for this issue or any others?
    YesNo

    If so, please explain the issue or behavior for which they were medicated

    Training Expectations/Goals:

    What are your specific expectations for training?

    What are your Top-3 goals for training?

    Is there anything else you would like us to know?

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    Note: ALL FIELDS ARE REQUIRED FOR SUBMISSION

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