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Intake Form and Rabies Upload

How did you hear about us?*

First name*

Last name*

Email*

Phone*

Birthday*

Month

Day

Year

Address*

Dog's Name*

Rabies Upload Here:*

Dogs Birthday or Adoption Date*

Dog's Breed or Mix*

Female or Male?*

Is Your Dog Fixed?*

Do you have a fenced yard?*

Yes

Partially

What exercise does your dog get? For how long? How often? *

Is your dog kennel trained?*

Yes

Needs more work

Where does your dog sleep at night?

Where is your dog when you are not home? *

Has your dog ever become possessive or aggressive over you, food or toys? Explain.*

Why did you get your dog?*

What are your training goals? (Examples: Leash manners, greeting people politely, reducing reactivity, improving recall, confidence building, puppy foundation skills, off-leash reliability, impulse control.)*

Check all un-desired behaviors that apply:

Aggressive

Anxious when left alone

Bolts at the door

Chews Furniture

Destructive when alone

Digs in yard

Escapes from yard

Eats poop

Excessive attention-seeking behaviors

Excessive barking when alone

Excessive barking when you're home

Guards food, toys or people

Jumps on family

Jumps on people

Mouthing and nipping

Pulls on leash

Steals food, things and trash

Understands but will not follow commands

Threatening: Biting family members

Threatening: Biting strangers

Threatening: growling or lunging at other dogs/animals

Urinates or Eliminates in the house

Urinates when excited

NONE OF THE ABOVE

Other

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Upload your dogs best photo*

I understand that the information provided above will be used to guide services, and I confirm that it is accurate to the best of my knowledge.

Signature*

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