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Private Training/Consultation Request
This form is extensive but it will provide us the best opportunity to assist you. You will have the option to save the form and resume working on it for a period of 7 days.
PLEASE READ: Training or Consulting sessions are available at our facility Monday-Thursday 3;30pm and later. Availability fluctuates based on class and/or trainer schedules We will do our best to accommodate requests.
NOTE: If you only want private training for routine obedience training or dog sports, please fill out the info for you and your dog, the waiver at the bottom and then skip right to the training box at the end.
Your Name
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First
Last
Phone
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Email
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Your Dog's Name
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Sex of Dog
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Please select
Neutered Male
Spayed Female
Male
Female
Age of dog
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Breed of dog
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If you are not sure, please provide your best guess.
Most recent vaccine date
MM
/
DD
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YYYY
We will require a vaccine record if your dog is attending our facility.
Reason for Request
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Behavior History
Please provide as much information as possible.
How often does the problem or problems occur?
List problem then frequency. Also include any other factors you consider remarkable. ie only at night etc.
When did you first notice the main problems ? At what age - How long ago?
What are the general circumstances for these problems to occur?
Have the problems changed in frequency or intensity? If yes, explain
Describe any other significant incidents
Dog's activity level
*
Please select
Low energy
Moderate energy
High energy
Excessive
Check all behaviors that apply
Excessive Barking
Rude and/or Obnoxious Behavior
Has bitten another animal
Has bitten a person
Shows teeth at you
Growls at people
Growls at animals
Fearful of people
Fearful of animals
Sound sensitive
Reactive
Humpy
Pushes your hand/arm to pet him/her
Barks at family members for attention
Guards people
Guards objects (like foodbowl)
Doesn't like certain people (men, boys, wheelchairs etc)
Check all that apply
Known history (had since pup)
No known history
Has medical condition(s)
Is on medication
Dog is overweight
Dog is underweight
Gastrointestinal
Genitourinary
Hemtalogical
Lymphatic
Musculoskeletal Pain
Neurological
Psychiatric
Respiratory
Skin
Weight Gain
Weight Loss
Describe how you would punish your dog and how your dog responds
Is your punishment effective?
If yes, how so?
Is this your first dog?
Yes
No
Why did you choose this dog?
Where did you acquire your dog from?
Breeder
Shelter
Private party (advertised)
Friend
Stray
Other
Please list the people living in your household including you. Include Ages for anyone under 18
How many hours on average is your dog left alone at home?
Also, who spends the most time at home?
Please list all other pets that are in the home. Species
Sex
Age
Breed
Leave blank if no other pets in your home
Who is your regular veterinarian and name of Veterinary Hospital?
*
Describe your dog's relationship with the other pets in the home. Friendly, Buddies, Hostile, Afraid etc.
Leave blank if no other pets in your home
Have you moved since acquiring your dog? If yes, how many times and how long since last move?
Leave blank if you have not moved since getting your dog.
Has your household changed since getting your dog? Addition or loss of people or pets?
Leave blank if no changes.
What type of area do you live in?
Please select
Rural
Suburbs
City/Resedential
What type of home do you live in?
Please select
Single detached
Semi detached or Town Home
Apartment/Condo
Other
Do you have a fenced yard?
Yes
No
At what age was your pet spayed or neutered? Did you notice any behavior changes ? If yes, please describe
If your dog is not spayed or neutered - has your dog been bred or do you plan to breed him or her?
Check all that apply
Dog sleeps in crate at night
Dog sleeps with me or another family member
Dog sleeps elsewhere
Dog is tied outside
Dog is housetrained
Dog is not housetrained or eliminates in the home
Dog is crated when alone at home
Dog is loose when alone at home
Dog is left outside when alone at home
Dog is confined to a pen, run or room when alone at home
Dog destroys things when left alone
My dog follows me everyewhere
My dog whines or cries when he/she can't get to me
My dog runs away when I call him/her
My dog lunges at other dogs when on leash
My dog lunges at other people when on leash
My dog does not like house guests
My dog loves house guests but a little too much
My dog urinates when meeting people and/ or other dogs
Dog urinates or even defecates only on certain family member's belongings
Sleeping questions are referring to overnight.
Previous Training
Trained at home
Started a training class but didn't finish it
Graduated a training class
Graduated 2 or more levels of training
Private professional trainer
Other
Has hunted (with a hunter)
Schutzhund work
Dog sports
Has won awards
Has done herding work
Select all that apply
Intentions: Please select what best describes your intention
*
Please select
Problem is not serious. I am curious about options
I would like to change my dog's behavior but it is not serious
the problem is serious but if it doesn't change that I will still keep my dog
Problem is very serious and if it remains unchanged, I will euthanize or give up my dog
Not sure
I have read, understood and accepted the polices as stated on the Wag and Train Policies Page at http://www.wagandtrain.ca/policies.html
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Yes
This is required in order for us to proceed.
Waiver. Can be signed with touch pad or mouse
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Clear
My signature on this form indicates the following. I understand that there is an assumption of risk and that animals can be unpredictable. I agree to indemnify and hold harmless, Wag and Train, its landlord, employees, associates, clients and all other parties. I accept full responsibility for my dog and any or all damages that my dog should cause or endure. I participate with an assumption of risk and am aware that dogs can cause injury or even death. I agree to the terms and conditions on this form and have read, understood and agreed to the Policies and Other Information, which can be found at http://www.wagandtrain.ca/policies.html. I agree that I will not engage in any negative, defamatory or derogatory postings on social media, online forums, reviews of any kind and will assume responsibility for my friends, family, associates etc., and agree to pay Wag and Train $5000 if this contract should be breached. I am responsible for seeking veterinary care for my dog in the unlikely event that this should be required. Refunds are only issued if a service is canceled or declined by the provider - Wag and Train.
You can sign here with your mouse or touch pad
SIGNATURE IS REQUIRED. Print and bring with you if needed.
TRAINING ONLY
Please state what you like private training for? ie. Routine obedience. Dog sports etc. Training sessions are request specific and not a set amount of time due to the variances in needs and responses.
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