Stay and Train Registration Form Thank you for taking the time to fill out our registration form. These details will help us better serve you and your dog. We look forward to working with you! Client InformationClient's First Name(Required)Client's Last Name(Required)Client's OccupationCo-Owner's First NameCo-Owner's Last NameCo-Owner's OccupationHome/Cell Phone(Required)Email(Required) Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Children & Ages(Required)How/where did you hear of us?Have you moved with your dog within the last 12 months?(Required)Select OneYesNoHave you added or lost any pets within the last 12 months?(Required)Select OneYesNoHave you added or lost any family members within the last 12 months?(Required)Select OneYesNoStudent Dog InformationStudent's Name(Required)Student's Age(Required)Breed (or mix)(Required)Male or Female(Required)Select OneMaleFemaleSpayed/Neutered?(Required)Select OneYesNoStudent Dog Medical HistoryList all medications your dog is currently takingVet ClinicVet's NameVet's AddressVet's PhonePlease list any current or past medical issues including surgeries, infections, etc.Other PetsOther Pet #1's NameOther Pet #1's AgeOther Pet #1's BreedIs your other pet #1 Male or Female?Select OneMaleFemaleIs your other pet #1 spayed/neutered?Select OneYesNoOther Pet #2's NameOther Pet #2's AgeOther Pet #2's BreedIs your other pet #2 Male or Female?Select OneMaleFemaleIs your other pet #2 spayed/neutered?Select OneYesNoAbout Your Dog's LifestyleDoes your dog have a crate?(Required)Select OneYesNoDoes your dog like the crate?Select OneYesNoWhere is the crate located?Does your dog chew or destroy the crate?Select OneYesNoHow many hours does your dog spend alone each day?Select One<1 hour1 - 3 hours3 - 6 hours7 - 9 hours9+ hoursDog's allergiesDo you take your dog to dog parks?Select OneYesNoDoes your dog pull on walks?Select OneYesNoIf your dog pulls, what have you tried to change their behavior?About Your Dog's HistoryHas your dog ever growled at a person or dog?(Required)Select OneYesNoIf yes, please describe what happenedHas your dog ever nipped/bitten a person or another animal before?(Required)Select OneYesNoIf yes, please describe what happenedIf your dog has nipped/bitten a person or animal, was there a tear, scratch, bruise, bleeding, or puncture? Tear Scratch Bruise Bleeding Puncture NOT requiring stitches Puncture requiring stitches Is your dog fearful or nervous about certain people/dogs/situations?Select OneYesNoIf yes, please describeHow does your dog respond to grooming or bathing?What trainers, boarding facilities, or pet services have you used for your dog in the past? (Name/City)Please list any of the following tools that you currently use or have previously used with your dog Martingale Collar Prong Collar Choke Chain E-Collar Bark Collar Citronella Collar/Spray Spray Water Bottle Clicker Extendible (Flexi) Leash Waist Leash Front-Attach Harness No-Pull Harness Regular Harness Head Halti Gentle Leader Others Please list any other tools you have usedAbout Your Dog's Training Goals5 Things You Like About Your Dog1.2.3.4.5.5 Things You Wish You Could Change About Your Dog1.2.3.4.5.PhoneThis field is for validation purposes and should be left unchanged. Δ