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Training Class In-take form

First name*

Last name*

Email*

Phone*

Address*

How did you hear about The Packhaus Dog training and Behaviour Modification?*

Which weekend day work for your schedule?*

Saturday or Sunday

Dogs Name, Age and Breed*

Dogs Sex*

Male

Female

Is your dog altered?*

Spayed/Neutered

Intact

How old was your dog when you got him/her?*

Where did you get your dog? *

(e.i. rescue, local shelter, adopted, breeder or other.)

Are your dog's vaccinations up to date?*

Yes

Titer

List any pertinent Medical issues*

Any physical limitations, recent surgeries/illness etc.

What is your dog's diet?*

Does you dog have any Allergies?*

Please describe any behavioural issues you might be dealing with:*

When did these behaviours start?*

How much Socialization did your dog get in the first 6 months of their life?*

How does your dog respond to new dogs out in public?*

Excitable

Friendly

Calm

Timid/Anxious

Fearful/Aggressive

Unruly and Lunging

Choose all that apply

How social is the dog, daily or weekly, and what kind of social situation is it?*

Off Leash dog parks, On leash interactions with all sizes and breeds, family dogs etc.

How does your dog react to strangers in your home?*

Friendly

Excitable

Calm

Timid/Shy

Fearful/aggressive

Jumping up/nipping

Nipping at ancles

Choose all that apply

What situation triggers your dogs excitement?*

Barking, whining, jumping up etc.

What situation triggers stress/distress in you dog?*

Are you reading these signs correctly?

Is your dog Aggressive/Fearful?*

Has your dog ever bitten a dog or human?*

Not puppy nipping but drawn blood, so a puncture or tear of the skin where the dog tasted blood.

What is your dogs daily exercise routine?*

What tools and equipment do you use when exercising your dog?*

Martingale, flat soft collar, prong collar, Harness, retractable or 6' leash?

What level of skills do you and your dog have?*

Basic

Intermediate

Advanced

Commands your dog responds to right away and remains in command?

Sit

Stay

Down

Stand

Come

Heel

Wait

Leave it

Hand Signals

What would you like to achieve with this class:?*

Is there anything you would like me to know to make your plan complete?*

Learning style, physical limitations etc.

Comments and Questions:*

Waiver: Check all boxes to indicate you have read and understand each point.

I represent that I am the legal owner of the dog(s) described. My dog is in good health, is current on all required vaccinations, is on a flea and tick regiment and has not been ill with any known contagious viruses in the last 30 days.

I agree to disclose anu previous or current medical issue or concerns of my dog so PackLeader Academy can determine suitability for training. PackLeader Academy reserves the right to refuse training services for my dog, should my dog display any serious or unwanted behaviour.

I release PackLeader Academy, its staff, owners, representatives, and agents, from any and all liability should my dog injure another dog or person, and I accept medical and legal responsibility for my dogs actions, and any and all liability, which I, or my dog may suffer, including but not limited to injury, sickness, damage, or death resulting from participation in Training Classes.

I agree to adhere to the training methods and equipment recommend as advised by PackLeader Academy. I understand that failure to follow instructions and recommendations may result in less successful training results. We do not guarantee success as it is based on many variables.

My dog may be recorded and photographed on camera and/or video, and its image and first name may be used for promotional material in print and social media.

Submit copy of vaccine records*

Today's Date*

Signature*

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