Dog Training Intake Form - Mindful Mutts LLC

This is our training intake form! If you are interested in pursuing any of our training programs, please fill out the form below. If we have not already, once we receive the form we will be in touch with you regarding the programs that we believe will best suit your dog's needs. If you have multiple dogs needing training, please fill out one form PER DOG.

Owner Name(s):*

Phone:*

Email:*

Address:*

Dog's Name:*

Dog's Breed:*

Dog's Sex:*

Neutered Male

Intact Male

Spayed Female

Intact Female

Dog's Size:*

Less than 20 lbs

20lbs - 50lbs

50lbs - 100lbs

Greater than 100lbs

Dog's Age:*

Veterinarian Clinic Name:*

Veterinarian Clinic Phone Number:

I affirm that my dog is up-to-date on their Rabies, DHPP, and Bordetella immunizations.*

By selecting this box, I affirm my dog is current on their required immunizations.

My dog is not up-to-date on their immunizations, but they will be by the first day of training.

Where and when did you acquire your dog?*

Please list any other pets in the home below, including their name, age, and species:*

Please list any other household members' names and ages:*

How many hours is your dog left alone each day?*

Where does your dog sleep? (Be Specific)*

What activities/exercises do you provide for your dog and how often?*

Does your dog have a history of aggression? (Growling, snapping, baring teeth, lunging, biting, etc.)*

Yes

No

If you answered YES, your dog does have a history of aggression, please explain below:

Has your dog ever caused injury to another dog?*

Yes

No

If you answered YES, you dog has caused injury to another dog, please explain below:

Has your dog ever caused injury to another person?*

Yes

No

If you answered YES, your dog has caused injury to a person, please explain below:

Do you use a crate?*

Yes

No

Describe your dog's typical daily routine. Please be as detailed as possible:*

What is your dog's regular food?*

What are your dog's regular treats?*

What are your dog's meal times?*

Has your dog attended training before? *

Yes

No

If YES, please describe the training your dog has received, including when and where.

What commands or tricks does your dog already know?*

Select the training program(s) you are interested in:*

Group Classes

Private Lessons

Day Camps

Board & Trains

What are you looking to get out of dog training? Short term goals and long term goals? Please be as detailed as possible.*

(Optional) More space to answer the previous question:

Select all that apply to your dog:

Please briefly explain anything you selected above:

Is there anything else you would like us to know about you or your dog? (Medical conditions, other behavioral issues, service dog, etc.)