Dog History

Owner Information

Last Name* First Name* Address* City* State* Zip Code* Phone (123) 456-7890* Email* Please verify Email*

Basic Dog Information

Name* Breed - You can select multiple breed types using CNTRL-CLICK* Sex* Spay/Neutered* How did you acquire your dog?* How long have you owned your dog?* Approximate Age*

Basic Health

Has your dog been diagnosed with Hip Dysplasia?* Describe any physical movement restrictions (1000 chars left)*

Eating

What kind of food do you feed your dog?*

Please share about any food allergies (1000 chars left)*

When do you feed your dog?*

How much food does your dog receive daily?*

Do you leave food out for your dog?*

Describe any dog treats you use and how you use them.*

Will your dog allow you to reach for it's food while eating or pick up loose food on the floor?*

Can you pet your dog while he/she is eating?*

Please share any other information about eating habits (1000 chars left)

Hygiene

Do you have your dog professionally groomed?*

How often do you bath your dog?*

Does you dog enjoy being bathed?*

Do you clip your dogs nails?*

Do you brush your dogs teeth?*

Describe any hygiene issues. (1000 chars left)*

Please share any other information about your dog's hygiene (1000 chars left)

Toys

Does your dog play with toys?*

Does your dog play tug-of-war?*

Will your dog easily give up a toy?*

Please share any other information about play habits (1000 chars left)

Sleep Habits

Does your dog sleep with you?*

If your dog sleeps with you will he/she move if asked to do so??*

Humane and Dog Interaction

Does your dog have any issues with people in your household?*

If yes then please describe the issues(s) (1000 chars left)

Does your dog have any issues with visitors to your home or yard?*

If yes then please describe the issues(s) (1000 chars left)

Do visitors bring their dogs to your home?*

Describe how your dog interacts. (1000 chars left)

Are there certain types of people or dogs your dog dislikes or fears?*

Please describe the issues (1000 chars left)

Does your dog jump on people*

Does your dog growl at people*

Has your dog ever bitten someone?*

Please describe the circumstances and injuries (1000 chars left)

Exercise

How many times a week is your dog walked?*

How far do you walk your dog?*

Behavioral Issues

Have you tried to deal with behavioral issues in the past?*

Describe the issues and how you addressed them. (1000 chars left)

Describe how you believe your dog acts when you are not home. (1000 chars left)

Describe your dog's behavior when he/she is happy (1000 chars left)

How does your dog react towards other dogs when you are walking him/her? (1000 chars left)

Has your dog ever climbed or jumped a fence?*

Please select any current issues

Traininig

Describe any tricks your dog can do (1000 chars left)

Tell us about any past formal training your dog has had. (1000 chars left)

Describe any commands your dog knows (1000 chars left)

Which side of your body does your dog walk on?*

Is your dog under control when walked?*

Select commands your dog knows*

WAIVER AND ASSUMPTION OF RISK AND AGREEMENT TO HOLD HARMLESS

I understand that participation in any dog training class is not without risk to myself, members of my family, or guests who may attend, or to my dog, because some dogs to which I (we) will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby waive and release K9KISS and any employees from any and all liability of any nature for injury or damage which may result from the action of a dog and I expressly assume the risk of any such damage or injury while attending any training class.

In consideration of and as inducement to the acceptance of my application for training membership in this dog training class, I hereby agree to indemnify and hold harmless Dawn Rice and K9Kiss and its employees from any and all claims by any member in my family or any other person accompanying me to any training session or while on the grounds or the surrounding area thereto as a result of any action by any dog , including my own.

Checking this box you are signing this form electronically.*

Enter Date of Signature*