Training Request Form

Basic Information

First Name
Last Name
Dog Owner's Occupation:
Dog's Name:
Breed:
Dog's Age:
Dog's Birthday:  mm/dd/yyyy
Sex:
--None--
Female in Tact
Female Spayed
Male In Tact
Male Neutered

What Training or Classes are you Considering?: Choose all that apply.

Use command (Mac) or shift (PC) for multiple selections.  

In-Home Private Training
Puppy Socialization/Obedience Class
Basic Obedience Class
Advanced Obedience (Drop-In Class)
Non-Competitive Agility
Walk n Train
Board n Train

Problems/Issues: What Issues are you currently experiencing with your dog?: Choose all that apply.

Use command (Mac) or shift (PC) for multiple selections.   

Aggression
Barking
Chewing
Digging
Fearful/Shy
Getting on Furniture
Housebreaking
Jumping
Mouthing/Nipping
Other
Separation Anxiety
Unruly in House

What are your expectations?

Previous Training

Has your dog had any previous training?

--None--
Yes- A Lot
Yes- Some
Yes- Very Little
No

If yes, please describe previous training and results:

Your Behavior

Do you discipline bad behavior?:
--None--
Yes
No

If yes, how do you discipline bad behavior?:

Do you reward your dog for good behavior?:
--None--
Yes
No

If yes, how do you reward good behavior?:

Are you afraid to tell your dog what to?:
--None--
Yes
No

Do You Feel Mean Telling Dog What to do?:
--None--
Yes
No

Your Dog's Behavior

How Does Your Dog Behave in the House?:
How Does Your Dog Behave in the Car?:
How Does Your Dog Behave in the Yard?:
How Does Your Dog Behave at the Park?:
How Does Your Dog Behave with Strangers?:
How Does Your Dog Behave with Children?:
How Does Your Dog Behave with Dogs?:

Has your dog ever bit a person?:
--None--
Yes
No

Has your dog ever been in a fight?:
--None--
Yes
No

Details on Bites/Fights:

What does your dog find rewarding? (select all that apply)

Use command (Mac) or shift (PC) for multiple selections.

Affection
Fetch
Other
Play Ball
Swimming
Toys
Treats
Tug of War
Walks/Hikes/Running

What are Your Favorite Things to Do with your Dog?:

How sensitive are you and how well do you take constructive criticism? 

1= Supersensitive, easily offended, easily embarrassed so please choose words carefully 

10= Ultra thick skin, appreciate straight forwardness, impossible to embarrass

--None--
1
2
3
4
5
6
7
8
9
10

How Much are you Willing to Change for the sake of your dog? 

1= I don't want to do anything and I'm starting to wish I got a cat

10= I will do whatever it takes because I love my dog more than life

--None--
1
2
3
4
5
6
7
8
9
10

What kind of exercise, fulfillment and games do you do with your dog and how often?

Please supply your vet's contact information in the field below as well as any medical conditions to be aware of.

Dog's Diet:

How did you hear about Thriving Canine?

Referred by:
--None--
Internet Search
Friend or Relative
Veterinarian
Festival Booth
Thriving Canine Radio
Yelp
Facebook/Twitter
Other
Other Canine Professional
YouTube

Referral Name if Referred by a Person:

Notes & Contact Information

Additional Notes: Is there anything else you think would be useful for us to know?

Street Address

City
State/Province
Zip
Phone
Mobile
Email

You will know your form was properly submitted if you are taken to the Thriving Canine home page after hitting submit button.

*If you are still seeing this form after hitting the submit button and you are not taken back to the home page, click the "Back" button on your browser and see which fields were left blank and put N/A in the empty space and hit the submit button again. If you are still having trouble. Just email me chad@thrivingcanine.com. We'll figure it out.