Request Form

Please fill out the following information to request a training session. If you are interested in training multiple dogs, please fill out a separate form for each dog. Please fill out all questions or form will not be properly submitted. Use N/A as opposed to leaving field blank.

Basic Information

Dog Owner's Occupation:
Dog's Name:
Dog's Age:
Dog's Birthday:  mm/dd/yyyy

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

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

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

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

What are your expectations?


Previous Training

Has your dog had any previous training?

If yes, please describe previous training and results:

Your Behavior

Do you discipline bad behavior?:

If yes, how do you discipline bad behavior?:


Do you reward your dog for good behavior?:

If yes, how do you reward good behavior?:


Are you afraid to tell your dog what to?:

Do You Feel Mean Telling Dog What to do?:

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?:

Has your dog ever been in a fight?:

Details on Bites/Fights:

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

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

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

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

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:

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?

Signed Waiver: 
By clicking this box, I am indicating that I have read and consent to the rules and regulations listed in the  Release of Liability Form should I choose to move forward with Thriving Canine services.

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

*If you are still seeing this form after hitting the submit button and you are not taken to the "Thank You" 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 We'll figure it out.