Step 1 of 4 25% Client InformationToday’s Date* Date Format: MM slash DD slash YYYY Client's Name* First Last OccupationCo-Owner’s Name First Last OccupationHome/Cell Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Children & AgesHow/where did you hear of us?Have you moved with your dog within the last 12 months?*YesNoHave you added or lost any pets within the last 12 months?*YesNoHave you added or lost any family members within the last 12 months?*YesNoDog InformationDog's Name:*Date of Birth* Date Format: MM slash DD slash YYYY Breed or Breed Mix*Weight*Sex:*FemaleMaleSpay/Neuter*YesNoWhere did you get your dog?*How long have you had your dog?*Why did you originally adopt your dog(s)?*Medical HistoryList all medications your dog is currently taking:*Vet Clinic:*Vet’s Name:*Vet's AddressPhonePlease list any current or past medical issues including surgeries, infections, etc. Other PetsNameAgeSpecies/BreedSex:FemaleMaleSpay/NeuterYesNoNameAgeSpecies/BreedSex:FemaleMaleSpay/NeuterYesNoAbout Your Dog’s LifestyleWhere is your dog when he is home alone?*Where does your dog sleep at night?*Does your dog have a crate?*YesNoDoes your dog like the crate?YesNoWhere is the crate located?Does your dog chew or destroy the crate?YesNoHow many hours does your dog spend alone each day?*<1 hr1-3 hrs3-6 hrs7-9 hrs9+ hrsWhat kind/brand of food do you feed your dog?*How much and how often does your dog eat?*Is food left out during the day for your dog to eat?*YesNoDog’s allergiesWhat kind of toys does your dog have daily access to? Nylabones Rawhides Stuffed animals Kongs Tennis balls Rope toys Frisbees Food-dispensing toys Hollow bones Bully Sticks Other Please list other toysHow long does your dog play with toys?Where are the toys kept when not in use?How often does your dog go on a walk?*Who walks your dog?*How long is the walk?*Does your dog have any other exercise activities?*What does your dog wear on a walk? (Harness, No-Pull Harness, Prong/Choke Collar, Head Halter, etc.?)*Do you ever walk your dog off leash?*YesNoDo you take your dog to dog parks?*YesNoDoes your dog pull on walks?*YesNoIf your dog pulls, what have you tried to change his behavior? About Your Dog’s HistoryHas your dog ever growled at a person or dog?*YesNoIf yes, please describe what happenedHas your dog ever nipped/bitten a person or another animal before?*YesNoIf yes, please describe what happenedIf your dog has nipped/bitten a person or animal, was there a tear, scratch, bruise, bleeding, or puncture?Check all that apply Tear Scratch Bruise Bleeding Puncture NOT requiring stitches Puncture requiring stitches Is your dog fearful or nervous about certain people/dogs/situations?*YesNoIf yes, please describe what happensHow does your dog respond to new people in your home?*How does your dog respond to grooming or bathing?*What is your reaction when your dog ignores you?*What trainers, boarding facilities, or pet services have you used for your dog in the past? (Name/City)*Please list any of the following tools that you currently use or have previously used with your dog: Flat Collar Martingale Collar Choke Chain E-Collar Bark Collar Citronella Collar/Spray Spray Water Bottle Clicker Extendible (Flexi) Leash Waist Leash Front-Attach Harness Back-Attach Harness Double-Clip Harness Head Halter Other Please list other tools About Your Dog’s Training GoalsList 5 Things You Like About Your Dog*List 5 Things You Wish You Could Change About Your Dog*What made you reach out to us for training assistance?*What would you like to accomplish through training?*How would your ideal dog behave?*Thank you for taking the time to fill out our registration form. These details will help us better serve you and your dog. We look forward to working with you! Please verify the information was entered by you. Thank you.I understand and agree to the policies at the bottom of this page.*YesNoTo submit your information, please hit send. If you do not receive confirmation the form has been sent, scroll up to make sure all required fields have been entered. Policies Paid pre-registration is required to reserve a space in class. There will be no refunds after class begins. Please make sure your dog’s vaccinations are up-to-date. Only healthy dogs may come to in-person classes and training. Owners should keep their dogs at home or reschedule private training in cases of sneezing, coughing, diarrhea or other potentially contagious symptoms. Owners are expected to maintain and reinforce training outside of the class setting. Children 8 and over are welcome at in-person group classes as long as they remain with their parents throughout class, and follow trainers’ instructions. At their discretion, instructors associated with Joyful Dog LLC have a right to refuse admission to or expel a dog/handler from class. Waiver I understand that attendance at a dog training class is not without risk to myself, my dog, members of my family or guests who may attend. I agree to release and hold Joyful Dog LLC, its instructors and teaching assistants, the training facility, and their respective officers, directors and employees harmless of any liability arising from this training activity and/or information or consultation provided by Joyful Dog LLC. I expressly assume the risk of damage or injury therefrom.