Virtual Coaching Intake Form

Please fill out all required fields for form to properly submit. To check if form has submitted, click "Fill out intake form" button again.

"*" indicates required fields

Name*

Partner/Spouse (Secondary Handler)

Preferred Pronouns

Address*

Street Address City State ZIP Code

Phone*

Email*

Dog's Name*

Dog's Age*

Dog's Breed*

Dog's Sex*

Dog's Weight*

Dog's Color*

How did you hear about us?*

Is your dog neutered/spayed?*

What vet do you currently use?*

Is your dog up to date on vaccinations?*

Upload a copy of vaccination records now? (Or email by first lesson)*

Please upload a copy of your vaccination records*

Max. file size: 256 MB.

Please list any medications your dog is currently on. Be sure to include monthly preventatives (heartworm and flea) as well as any as needed medications(for anxiety or car rides) and supplements.*

Has your dog every needed to be muzzled for a grooming or veterinary procedure?*

What brand of food does your dog currently eat?*

Describe your dog's feeding ritual.*

What type of treats do you currently use when training your dog?*

Do you crate your dog? If so, when?*

What type of equipment have you used with your dog for leash walking? (Flexi/retractable leash, front/back clipping harness, head halter, choke chain, prong collar, etc)*

What cues does your pet already know?*

Have you ever used a shock collar?*

Are you considering using a shock collar? (This includes an invisible fence.)*

How do you currently discipline your dog?*

How do you currently reward your dog?*

Have you ever used a clicker to train a dog?*

Was your dog rescued or purchased from a breeder? Please describe the details of either situation. Age rescued? How long have you had the dog?*

How does your dog react to other dogs on leash?*

Has your dog ever growled at another dog? If so, what were the circumstances?*

Has your dog ever growled at a person? If so, what were the circumstances?*

Has your dog ever bitten another animal? If so, please explain.*

Has your dog ever bitten a person? If so, please explain.*

List things your dog is afraid of:*

List things that your dog is aggressive towards:*

Have you and your dog ever participated in dog training with another company? If so were they private lessons or group classes? Where were they and what was the topic covered?*

What are your immediate goals for training?*

What are your long term goals for training?*

What time do you prefer to meet for your virtual lessons?*

I understand that all sales are final. Please initial.*

I understand that this package will expire four months after the purchase date. Please initial.*

I understand that in the event of severe weather or other emergency class may be postponed to the following week at the trainers discretion. Please initial.*

I understand that dogs must be up to date for their age on vaccinations in order to participate and will require proof of vaccinations. Please initial.*

I accept all liability if any humans, animals, or property are harmed during the training process. Please initial.*

I give permission for my dog to be photographed or videoed and shared on the website or social media.

I give permission for me and my dog to be photographed or videoed and shared on the website or social media.

I understand that if I fail to give 24 hours notice to cancel my lesson, I will be charged a $50 no show fee. Please initial.*

919-645-8203

Info@howlingmoonpetcare.com

Virtual Coaching Intake Form

Howling Moon Pet Care