Hybrid Questionnaire

Hybrid Dog Training Questionnaire
Address
Address
City
State/Province
Zip/Postal
BEST NUMBER TO REACH YOU?

List ALL Dogs living in your home. Click + button for additional dogs after the first

HOW LONG HAVE YOU OWNED THE DOG(S)?

WHAT VET CLINIC DO YOU USE?

Does your dog(s) have any medical conditions or is your dog(s) on a restricted diet?
Does your dog(s) have any allergies?
Does your dog(s) take any medications?
May we consult with your vet?

WE REQUIRE EVERY DOG WHO PARTICIPATES IN OUR BOARD & TRAIN PROGRAMS TO HAVE CURRENT VACCINATION RECORDS AND TO BE FREE FROM PARASITES. Please upload your dog(s) Vaccination History Record(s). THIS TRAINING QUESTIONNAIRE WILL NOT SUBMIT IF A FILE IS NOT ATTACHED. IF YOU DON'T YET HAVE VACCINE INFO, UPLOAD A PHOTO OF YOUR DOG, THEN NOTIFY US IMMEDIATELY(Max file size is 2mb, please submit files in one of these formats pdf, jpg, or doc.). Your dog needs to be up-to-date on the following vaccinations: *Rabies *Bordetella *Distemper *Leptospirosis *Fecal Float. THE FECAL TEST MUST INCLUDE TESTING FOR GIARDIA. We recommend that you get their first fecal test about 4 weeks out from their start, so that if they test positive you have time to treat & retest just before their start date. The fecal test MUST include testing for Giardia, and your dog must be negative for the parasites, ova/cysts and the antigen. Please note that standard fecal tests usually do not cover Giardia, and you must specifically request that the fecal test include it. The stool sample will usually need to be sent to a lab, and results are normally available within a couple of days.

Maximum file size: 10MB

Maximum file size: 10MB

Is your dog microchipped?
Does your vet ever muzzle your dog(s) for routine procedures? Please check all that apply
What type of collar does your dog(s) normally wear?
Why did you get your dog(s)? Please check all that apply
Have you owned other dogs in the past?
Has your dog ever been in a dog fight?
Does your dog let you put on/take off collars?
Is your dog muzzle conditioned?
Does your dog let you groom/brush him/her or touch his/her nails?
HAS ANY PROFESSIONAL MEDICAL TREATMENT BEEN NECESSARY FOR PEOPLE AS A RESULT OF ANIMAL AGRESSION?
Have any legal authorities ever been contacted as a result of aggression?
Has your dog ever threatened (growl, snarl, snap, bite) any person?
Has your dog ever threatened (growl, snarl, snap, bite) any companion animal?
Has your dog ever injured any person?
Has your dog ever injured any companion animal?
Has your dog ever delivered multiple bites, scratches during one incident?
Has your dog ever delivered one or more deep puncture wounds or bites with tearing motion?
Have you or anyone else tried to correct the aggression?
Have you considered re-homing your dog?
Have you considered euthanasia?
Do any caregivers (vet, groomer, etc) sedate or restrain your dog for routine care?
Does your dog know any commands or tricks?
Check all methods used to train your dog.
Check all training aids or tools used with your dog.
Is your dog reliably house trained?
Have you ever used potty or pee pads to house train your dog?
Are you currently using potty or pee pads to house train your dog?
Are you currently using potty or pee pads to house train your dog?
Is your inside dog ever confined when you are home?
Please check all that apply.
Tell us about your dog's outside area
Do you take your pet on outings or walks?
If no, is it because of your dog's behavior?
How long are most outings or walks?
How often does your dog eat each day?
Has your dog gained weight in the past three months?
Has your dog's coat changed in the past three months?
What negative behaviors are you experiencing?

Please list the names, ages & gender of people in the household. Also list any animals, their species, age, name and gender not listed earlier.*

AGREEMENT and RELEASE - PLEASE CHECK THE SERVICE RECOMMENDED BY YOUR TRAINER

PLEASE CHECK THE SERVICE RECOMMENDED BY YOUR TRAINER

GOOD DOG! COACHING REMOTE SUPPORT

TERMS AND CONDITIONS

Payment is due in full at the time of scheduling to reserve your dog's Board & Train HYBRID Program. Accepted forms of payment are Cash, Check or Credit/Debit Card. When paying by credit/debit card a convenience fee will be added. For clients outside our normal 10 mile travel radius (we are in Lilburn) a trip charge per visit will be added to your total for your in home One on One training sessions. Up to 20 miles $20 per trip, 21- 30 miles is $35 per trip, 31-40 miles $45 per trip, 41-50 miles $60 per trip.

By checking this box I agree to the above conditions.
The terms and conditions of this agreement may not be changed orally. Any deviation from this agreement does not alter the remaining portions. This agreement is not transferable. This agreement is between Good Dog! Coaching (including all agents, representatives, or associated parties) (RELEASEE) and the above "Client" (RELEASOR). The In Home training sessions that occur after the Board & Train Progam shall be completed with in 120 days of the first go home session. All Unused Sessions are forfeited at the end of the 120 day period. No Refunds for unused Sessions. Clients that contact us to reschedule appointments within 24 hours of a scheduled appointment will be charged a rescheduling fee of $100.
By checking this box I agree to the above conditions.
Good Dog! Coaching agrees to instruct the "Client" in Good Dog! Coaching philosophies and preferred method of training for the amount of time allocated to the session. Client agrees that Good Dog! Coaching is in no way responsible for the behavior of the animal during, or following, all sessions. Good Dog! Coaching does not guarantee specific results, as results are largely dependent on owner/handler compliance and consistency. We do guarantee to provide the services as described in this contract. Client agrees to complete all provided homework while their dog is in training.
By checking this box I agree to the above conditions.
If at any time during the Course Period Good Dog! Coaching representative feels the animal is ill, abused, or exhibiting any behaviors that interfere with teaching methods or endanger the health and safety of any participants or bystanders, including the animal, OR Good Dog! Coaching representative feels the "Client" has motives, goals, or demands that are not in concert with Good Dog! Coaching Code of Ethical Conduct, our representative may abort the session, alter the service selection, and/or alter the length of the Course Period.
By checking this box I agree to the above conditions.
By Checking below, I understand that every animal reacts in a different manner to training and that animals are by nature unpredictable. Therefore training requires full attention and total awareness at all times. Animals may, without warning cause injury to humans and/or other animals and I, the undersigned as RELEASOR, in consideration of Good Dog! Coaching as RELEASEE, release and indemnify RELEASEE's, owners, heirs, executors, administrators, successors, employees, agents, directors, officers, and anyone acting in the scope of business as a representative of Good Dog! Coaching as to attacks, bites, scrapes, scratches, mauling, or all of them, by animals, to any persons or animals including my own, before, during and after any sessions with Good Dog! Coaching personnel. I hereby release Good Dog! Coaching and each event site's property owner from any and all liabilities to either my dog or myself, associated with my participation in the above described activities. Furthermore Good Dog! Coaching will not be responsible or libel for any damages due to the uncontrolled behavior of any animal or negligence on the part of the dog's owner/handler before, during or after training. I have read and fully understand these guidelines. My participation in this activity is at my own risk, and I do so freely. This contract may not be changed orally.
By checking this box I agree to the above conditions.
By Checking below, I the Owner fully understands the tools and techniques that are used to train and modify the behavior of their dog and agrees to the tools and techniques which may include Prong Collar, Bark Collar, Remote Training Collar, Slip Lead, Pet Convincer, Muzzles, Flat Buckle collar, Dominant Dog Collar, Martingale collar, Bonker.
By checking this box I agree to the above conditions.
Photo/Video Release (All Clients) I hereby assign and grant to Good Dog! Coaching & Pet Care the right and permission to use, reproduce, distribute, and publish the photograph(s), film(s), videotape(s), audio and video recording(s), electronic representation(s) and/or sound recording(s) made of me and/or my dog(s) at any time during the training and/or boarding of my dog(s) by Good Dog! Coaching & Pet Care, and I hereby release Good Dog! Coaching & pet Care from any and all liability resulting from such use, reproduction, distribution, and publication. I hereby authorize the reproduction, sale, distribution, copyright, exhibit, broadcast, and/or electronic storage of any and all such photograph(s), film(s), videotape(s), audio and video recording(s), electronic representation(s) and/or sound recording(s) without limitation at the discretion of Good Dog! Coaching & Pet Care and I specifically waive any right to any compensation I may have for any of the foregoing.
By checking this box I agree to the above conditions.

PICK UP/DROP OFF AGREEMENT

Board and Train dogs will be dropped off by the client unless other arrangements have been made. All Board & Train programs include 6 hours of private training. The 6 hours typically works out to: (1) 2-hour Day before Go Home session at Good Dog! Coaching & Pet Care location; (1) 2-hour In Home training session on the day of return; and (1) 2-hour follow-up training session. At the day before go home - and drop off go home sessions, we will go over all that your dog has learned and work with you on how to start implementing the training into your daily life. Follow-up lessons are provided to help ease the transition of your dog back into your home and to help you maintain the high standard for behavior we have at our kennel. When bringing your dog for a Board and Train, all we need is your dog's food and any medication your dog needs, including flea/tick and/or heart worm (only if they need to be given to your dog while your dog is with us.) Do NOT bring any bedding, toys, water/food bowls, treats or bones! DROP OFF AGREEMENT: When dropping off your dog at our facility, you will need to stick to the exact time that we agreed upon. We are on a schedule with other guest dogs. Therefore, we are pulled away from training to meet and greet you to make sure your dog gets onto the property safe and securely. Upon arrival, your dog must be on a leash/collar setup from which they cannot slip out of (and a muzzle if previously discussed) when going from your car to our property and during the hand-off. Your dog may be nervous, scared or excited and any of those things can lead to your dog escaping the collar and running off or around the property, which is a safety issue for your dog, us and other dogs on the property. When you arrive, you will hand off your dog to me. You are NOT to hug, kiss, bend down or use a high-pitch voice at all. Instead, please just hand off the leash to me. Not following these instructions can jeopardize the safety of everyone involved. We will bring the dog back and put him/her in a kennel. You may leave food and medication and any further instructions with us. We do not allow non-employees into the actual kennel area as we may have other guest dogs with serious issues, and it will create an unsafe environment for all of the dogs as well as staff and yourself.
By checking this box I agree to the above conditions.

PHYSICAL ACTIVITY AGREEMENT

Physical Activity Agreement: Your dog will be staying in a home environment and not living in a padded room. Your dog spends a good amount of time in the outside world doing lots of things around lots of natural objects, dirt, grass, cement, trees, fencing, bushes, etc, possibly interacting with other dogs, and humans. It is likely that your dog is going to get scratched, bumped, or bruised. Your dog will most likely get some wear and tear on him/her. Imagine when you went to summer camp for a few weeks, you get a little banged up from all of the activities. Things are bound to happen even though we have taken special care in maintaining a high standard of safety and cleanliness. As Owner, you acknowledge and understand that there are certain risks involved in pet training, boarding, and care. You release, indemnify, and agree to hold Good Dog! Coaching & Pet Care harmless from any and all manner of damages, claims, loss, liabilities, costs or expenses, causes of actions or suits, whatsoever in law or equity, (including, without limitation, attorney’s fees and related costs) arising out of or related to the services provided by Good Dog! Coaching & Pet Care.
By checking this box I agree to the above conditions.

BY TYPING YOUR NAME ABOVE YOU AGREE TO ALL THE ABOVE STATEMENTS AND THAT THIS IS VALID AS YOUR SIGNATURE.
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