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* 1. Owner's Information

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* 2. How did you hear about us?

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* 3. What is the best way to contact you?

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* 4. Dog's name?

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* 5. Gender of your dog?

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* 6. Breed

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* 7. Dog's age

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* 8. How old was the dog when you acquired it?

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* 9. Has your dog been?

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* 10. Where did you acquire your dog?

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* 11. Is this your first dog?

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* 12. Have you ever trained a dog?

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* 13. Briefly state what you would hope to accomplish during training?

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* 14. Is your dog house trained?

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* 15. Is your dog crate trained?

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* 16. How does your dog do in the crate?

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* 17. Describe any previous obedience training.

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* 18. Level of Success?

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* 19. What commands currently work best?

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* 20. What member of the family has the best control of your dog?

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* 21. Does your dog know how to walk on a leash?

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* 22. Is your dog good with other dogs?

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* 23. Does your dog react negatively to any of the following? (check all that apply) 

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* 24. Check the behavior problems that you are having with your dog. (check all that apply)

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* 25. Does your dog exhibit any of the following behaviors? (check all that apply)

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* 26. Describe any of the above in more detail if needed

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* 27. Is anyone in your family afraid of your dog? If so please describe

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* 28. Do you ever muzzle your dog for safety?

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* 29. Has your dog ever bitten a person?

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* 30. Has your dog ever been reported to animal control for biting?

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* 31. Has your dog every attacked another animal? If yes, please explain

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* 32. Please give any additional information regarding fear or anxiety in your dog

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* 33. Describe any situations where your dog appears fearful and/or aggressive. For example thunder, fireworks, loud noises etc.

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* 34. Veterinarian Information

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* 35. Is your dog current on all vaccinations including rabies? Note: Any dog signed up for training must be up-to-date with vaccines.

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* 36. Would you provide proof of vaccinations from your vet?

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* 37. Please give the date of your dog's last heartworm preventative

Date

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* 38. What was the date of your dogs last flea and tick treatment?

Date

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* 39. Please list ALL medications your dog is currently taking

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* 40. Please list any medical problems your dog currently has or had in the past

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* 41. Please list any other information you feel we need to know

T