Owner's First and Last Name
Owner's Phone Number(s)
Owner's Email(s)
Owner's Full Address (Number, Street, City, State, Zip Code)
Emergency Contact Name and Phone Number(s) Please list who we should contact in case of an emergency if we are unable to reach you. (Cannot be Owner's Contact Information).
Do you have a means of transportation?
Which program are you signing up for?
How did you hear about us? Search Engine (Google, Yahoo, etc) Facebook Instagram Blog or Publication Recommendation from Friend, Family or Previous Client Veterinarian, Groomer, or pet related Services Other
If you selected Other, please fill in below.
Do you have any additional questions regarding E-Collar training that we utilize in all our programs? Your trainer will answer all your concerns.
Dog(s) Name
Dog(s) Breed
Dog(s) Weight
Dog(s) Age (Please note that we have a minimum age requirement of 5 months of age to start a training program).
Dog Gender (If you are signing up more than one, please select Other) Male Female Other
If you selected Other, please fill in below:
Has your dog ever before used an electric--invisible fence?
Is your dog currently on any medication? If so, please explain)
What type of food does your dog eat and how often and how much are they fed? ---What are your dog's eating habits and restrictions? (picky eater, allergies, etc.)---What type of treats or supplements do you normally give them and how often?
Veterinarian Name and Office
Groomer (if applicable)
Daycare (if applicable
Boarding Kennel (if applicable)
Where and How did you get your pup?
Treated for flea and tick? Yes No
Neutered or Spayed (if not, please confirm last heat cycle for female in Other. Yes No Other
Other
Is your dog up to date on RABIES, BORDETELLA, PARVO, DISTEMPER, AND LEPTOSPIROSIS? ---Please note that the Bordetella vaccination must be up tp date or given at least 3 days prior to the start of the training program if administered nasally or by mouth. If the vaccination is given by injection, it must be at least 10 days prior to the start of training.---Please ensure that you have, or will send, a copy of your pet's up to date vaccination records to your trainer within 10 days of your start date. Yes No
How long have you owned your dog?
Any past or current training? If so, please list where they received training and what training techniques were used (Reward based, assertive, aversive, etc.)
What are the main issues and concerns you are experiencing with your pup? Please provide details.
What are you hoping to accomplish with your training program? What are your goals for your pup?
Is your dog crate trained If so, how often are they crated? (During the day, at night, etc.)
Does your pup have any potty training difficulties? If yes, how often do they have accidents and where does it most commonly happen?
Is your dog typically a chewer?
Does your dog have a separation anxiety? If so, please explain.
What does your daily routine with your pup look like? (Exercise, play, games, rest, and how often, etc.)
How is your dog with strangers, kids, dogs, etc? (Friendly, calm, ambivalent, fearful, aggressive)
How often is your dog around strangers, kids, dogs, etc?
Is your dog food (and-or) toy possesive?
Does your dog have a prey drive? Do they like to go after small animals? (Cats, squirrels, chipmunks, etc.)
Has your dog ever attempted to bite a person or another dog? If so, please explain in detail and how the situation was handled.---(Such as most recent bite history, how long these behaviors have persisted, behaviors and postures leading up to the bite, and the events that led to the bite)
Please provide payment for the program in order to lock in dates. For the Board and Train, please pay a 50% deposit. As a reminder, your remaining balance is due the first day of training, I am paying by debit or credit card. I am paying by using Venmo. I have already paid over the phone or by emailed invoice or discussed other options with Ruff Haus K9.
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