Basic Manners Intake Form

Distracted Dog - Group Class Registration Form

To help us ensure your pup will be happy and comfortable in the group class environment, please answer the following questions as thoroughly as possible!

First Name *

Last Name *

Phone *

Email *

Dog's Name *

Dog's Age *

Disctracted Dog - Group Class Curriculum

Please read the following skills that you will learn in class and check the box below to show that you understand what it being taught.

Focusing around Distractions
Name Recognition
Management Techniques
Polite Leash Skills
How to deal with distractions
Get your dog to listen without treats in your hands

I understand that I have elected to sign up for a group class with a set curriculum, and that my training goals align with the skills being taught in the selected class.

Please explain your top 3 training goals for your dog from the list above: *

Individual Behavior Concerns

Our group classes are not designed to cover any individual training or behavior concerns such as reactivity, aggression, resource guarding, anxiety, or other similar concerns.

These concerns would require an individual, custom training plan that can be addressed in a Private Training Program.

Individual Behavior Concerns *

I read and understand the above information about addressing individual behavior concerns in a Private Training Program rather than a group class. Additionally if my dog is displaying high levels of anxiety, stress, or reactivity, we may be asked to switch to private lessons at our facility to continue learning the class curriculum.

Previous Training Experience

Has your dog had any previous formal training?: *

Yes
No
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If "Yes", what company did you train with?

What type of classes/lessons did you enroll in?:

How many lessons did you attend?:

How did your dog respond to the training?:

How do you feel about the training and results?

Please check all types of training equipment you have used with your dog: *

4ft standard leash

6ft standard leash

Retractable leash

Flat collar

Martingale collar

Head collar

Prong collar

Slip lead

Electric collar (e-collar, e-stim)

Slip/choke collar

No-Pull Harness

Clicker

Treats

Toys

How do you tell your dog they did something “wrong”?: *

Saying “no”

Leash correction/pop

Tap on nose/bum

Ignore

Other

If you answered "other" as to how you tell your dog they did something "wrong" please expand

How does your dog react to seeing other dogs on leash? Please explain body language and behaviors *

How does your dog react to strangers: Explain specific behaviors & body language: *

Is your dog afraid of any specific items or noises? If yes, please explain:

Any sensitive areas on their body: If yes, please explain:

Any allergies or dietary restrictions: If yes, please explain: *

Does your dog have any physical limitations?: If yes, please explain

Any other useful information?:

Rabies Vaccine Records *

Distemper Vaccine Records *

Fecal Test Results (within last 6 months) *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Distracted Dog Intake Form