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First Name *

Last Name *

Phone *

Email *

Address

Street Address *

City *

State *

Country *

Postal code *

Dog's Name *

Dog's Age *

Dog's Sex: *

Dog's Breed *

Alter Status *

Health issues (if any)

Medications currently taking (if any)

Vaccine History *

Describe your dog's daily routine

Does your dog live with any other animals? If so, please describe their relationship *

Has your dog ever bitten a person or another animal? If so, please describe the circumstances *

Where did you acquire your dog?

Do you know anything about your dog's experiences before they came to you?

How long have you had your dog? *

Are there any specific triggers that cause your dog to behave negatively (e.g., certain noises, people, animals, situations)? Please describe

Please list any previous training your dog has had (include trainer’s name, techniques used, commands learned, etc

Current behavioral concerns: *

Preferred training location: (in home, in trainer home, in public, etc)

How did you hear about Practically Positive Dog Training? *

Any additional info you'd like to share? (Ex: My dog already knows sit, down, etc.)

Do you have another dog you'd like to provide information for?

Emergency Contact Name/Phone *

I understand the risks associated with enrolling in our dog training classes and agree to assume the risks to myself and my household. I also agree to follow all safety requirements that Practically Positive, LLC imposes as a condition of enrolling my dog. Please read the Terms and Conditions of this agreement. *

I understand

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Date *