Dog TrainingComprehensive Training Registration FormPlease make sure to schedule your free consultation before filling out this form. "*" indicates required fieldsStep 1 of 714%Owner InformationName* First Name Last Name Email* Address*City*State*Zip*Cell Number*Pet InformationPet Name*Birth Date*Species (Dog, Cat, Rodent, Bird, etc)*Breed*Color*SexPet InformationWhere did you acquire your pet?* Adopted from rescue/foster family Breeder or pet store Friend or Family member Stray or Found petApproximately, how old was pet when you got them?*Spayed/Neutered* Spayed Female Neutered Male Intact Female (Not Spayed) Intact Male (Not Neutered)If not spayed or neutered... what is the reason & do you plan to spay/neuter?Does this pet wear an ID tag?*Vet InformationDo we have your permission to contact your veterinarian for vaccine information and health/behavior history? Yes NoPrimary Vet*Vaccinations Current*Approx Weight*Medical Alerts (Current and past medical problems, including food or environmental allergies*Do they take any medications? (Besides heartworm and flea prevention)*Are they current on heartworm and flea medications? What day of the month is it given and what brand are they on?*Pet BehaviorMeals - What brand does your pet eat? How much? How often?*Any known health problems or current medications?*Does anything make your pet nervous or anxious?*Have they bitten or snapped at any person or pet? Please explain*How much of exercise do they get each day? What kind?*Dogs only: Is he/she crate trained?*List 3 words to describe this pet?*Pet BehaviorWhat category best describes your household?* I am seeking help out of curiosity - the problem is not that serious I would like to change the problem, but it is not that serious The problem is serious, but if remains unchanged, that's all right The problem is very serious, but if it remains unchanged I will keep my dog The problem is very serious. If it remains unchanged, I will have my dog euthanized or give him/her upWhich educational program interests you the most?* Private In-Home or On-Site Training Session Group Obedience Classes One-Day Workshops on specific skill (Leash Manners, Recall (Come) or Tricks Workshops) Online Educational Programs (Learn on your own time!) Not sure, would like a phone consult to discuss options Day Training Program (I come to YOUR house 3 times a week - Alternate to Board n Train) Board and Train (Minimum of 2-4 weeks - In Beth's home - VERY limited as I only take 1-2 client at a time)What day(s) do you prefer to do training sessions?* Weekday Daytime Weekday Evenings Sat or Sun Daytime Sat or Sun EveningsSocialization Problems* Not good with dogs - On Leash Not good with dogs - Off Leash Not good with people Doesn't know how to play nicely Scared/Fearful/Insecure (give more details below) None of the above OtherBehavior Problems* Aggression with dogs Aggression with people Separation anxiety (barking, accidents, destruction, etc.) Chewing/Destruction House-training - Accidents in the house Guards Toys/Food/Territory/People Anxiety/Fears (Please give more details below) None of the above OtherPet BehaviorTraining Challenges*Does this pet live with children?*Does this pet live with other pets?*How long are they left alone during the day and where do they stay?*How do you respond when they do something good?*How do you respond when they do something bad?*Who can we thank for referring you to us?After you submit this form you will be redirected to purchase a dog training package.Please check the box to verify that you're human.