Good Dog! Coaching & Pet Care Training Questionnaire

Training Questionnaire Board & Train HYBRID

Welcome to Good Dog! Coaching where your pet's health and happiness are our first priority. At Good Dog! Coaching, we know your pet is a member of your family and that his or her happiness is about much more than food and water - it's about love and understanding the personality and temperament of every pet we meet. It is very important that Good Dog! Coaching clients are informed and educated. We ask many questions in an effort to customize your training experience. Please read very carefully, ANSWER ALL QUESTIONS IN DETAIL where asked and feel free to ask any questions you may have at any time. OUR GUARANTEE: At Good Dog! Coaching your satisfaction is top priority. We know you expect the best in regards to care, dependability & service for you and your pet. We agree with you and promise to deliver.

Please be careful to answer each "Required Question". Leaving a "Required Question" unanswered can result in the form not submitting properly and to the loss of all entered information. Before clicking the submit button, double check that you have answered all "Required Questions". AFTER CLICKING THE SUBMIT BUTTON, WAIT FOR THE PAGE TO REFRESH UNTIL YOU SEE A CONFIRMATION STATEMENT CONFIRMING YOUR FORM PROCESSED. IF YOU MISSED A QUESTION YOU WILL SEE THE FORM AGAIN, SCROLL DOWN TO SEE THE QUESTION(S) YOU MISSED. IT WILL BE HIGHLIGHTED.
While this is a lengthy form, each questions is asked in an effort to gather as much information as we can so we can tailor the training program to your dog.
Date
DATE
MM slash DD slash YYYY
Name*
NAME
First Last
Address*
ADDRESS

Street Address Address Line 2 City State ZIP Code
Email*
Cell Phone*
Day Phone*
BEST NUMBER TO REACH YOU?*
- CELL
- DAY PHONE
Emergency Contact Name (if you are unavailable)*
First Last
Emergency Contact Cell Phone*
HOW DID YOU HEAR ABOUT US?*
SEARCH TERM, OR NAME OF FRIEND, VETERINARIAN, REFERRAL PERSON OR OTHER*
SEARCH TERM, OR NAME OF FRIEND, VETERINARIAN, REFERRAL PERSON OR OTHER
WHY DID YOU CHOOSE GOOD DOG! COACHING?*
WHY DID YOU CHOOSE GOOD DOG! COACHING?
List ALL Dogs living in your home. Click + button for additional dogs after the first*
ANIMAL'S NAME AGE & WEIGHT BREED OR MIX MALE OR FEMALE SPAYED OR NEUTERED
HOW LONG HAVE YOU OWNED THE DOG(S)?*
DOG #1 DOG #2 DOG #3 DOG #4
WHAT VET CLINIC DO YOU USE?*
NAME OF CLINIC ADDRESS CITY & ZIP CODE STATE PHONE
Does your dog(s) have any medical conditions or is your dog(s) on a restricted diet?*
- YES
- NO
If yes, please elaborate.
IF YES, PLEASE ELABORATE.
Does your dog(s) have any allergies?*
- YES
- NO
If your dog(s) has allergies, please list and elaborate.
IF YES, PLEASE ELABORATE.
Does your dog(s) take any medications?*
- YES
- NO
If yes, please list each with name, dosage and how many times per day.
IF YES, PLEASE ELABORATE.
When was your last vet visit?*
WHEN WAS YOUR LAST VET VISIT?
Reason for vet visit?*
REASON FOR VET VISIT?
May we consult with your vet?*
- YES
- NO
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.*
Max. file size: 2 MB.
Additional File
Max. file size: 2 MB.
Is your dog microchipped?*
- YES
- NO
Does your vet ever muzzle your dog(s) for routine procedures? Please check all that apply*
- Dog #1
- Dog #2
- Dog #3
- None of the above
What type of collar does your dog(s) normally wear?*
- Buckle/Clip
- Choke/Slip
- Pinch/Prong
- Other
If "Other" Please explain
Why did you get your dog(s)? Please check all that apply*
- Companionship
- Protection
- Therapy
- For Child/children
- For Breeding
- Working Dog
- For Spouse
- As a gift
- For Competition/Show
- To Perform Service Tasks
- Other
If "Other" Please explain
Why did you choose this breed/type of dog?*
Have you owned other dogs in the past?*
- YES
- NO
What breeds have you owned before?
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?*
- YES
- NO
IF YES, PLEASE EXPLAIN THE EXTENT OF INJURIES AND TREATMENT.
HAS ANY PROFESSIONAL MEDICAL TREATMENT BEEN NECESSARY FOR PETS AS A RESULT OF ANIMAL AGGRESSION?*
- YES
- NO
IF YES, PLEASE EXPLAIN THE EXTENT OF INJURIES AND TREATMENT.
Have any legal authorities ever been contacted as a result of aggression?*
- YES
- NO
Has your dog ever threatened (growl, snarl, snap, bite) any person?*
- YES
- NO
Has your dog ever threatened (growl, snarl, snap, bite) any companion animal?*
- YES
- NO
Has your dog ever injured any person?*
- YES
- NO
Has your dog ever injured any companion animal?*
- YES
- NO
Has your dog ever delivered multiple bites, scratches during one incident?*
- YES
- NO
Has your dog ever delivered one or more deep puncture wounds or bites with tearing motion?*
- YES
- NO
Have you or anyone else tried to correct the aggression?*
- YES
- NO
- DOES NOT APPLY TO MY DOG
Have you considered re-homing your dog?*
- YES
- NO
Have you considered euthanasia?*
- YES
- NO
Do any caregivers (vet, groomer, etc) sedate or restrain your dog for routine care?*
- YES
- NO
IF YOU ANSWERED YES TO ANY OF THE PREVIOUS QUESTIONS, PLEASE STATE WHEN AND ELABORATE WITH SPECIFIC DETAILS. YOUR INPUT IS EXTREMELY IMPORTANT!!!
IF YOUR DOG HAS HAD ANY BITE, NIPPING INCIDENTS PLEASE STATE WHEN AND ELABORATE WITH SPECIFIC DETAILS. YOUR INPUT IS EXTREMELY IMPORTANT!!!
Does your dog know any commands or tricks?*
- YES
- NO
Which commands or tricks?*
Check all methods used to train your dog.*
- Food Rewards
- Non-food Rewards
- Corrections
- Clicker
- None
Check all training aids or tools used with your dog.*
- Head Halter
- Body Halter
- Martingale Collar
- Slip Leash or Choke Chain
- Pinch or Prong Collar
- Remote or E Collar
- Invisible Fence or Interior Electronic Containment System
- Bark Collar
- Clicker
- Target
- None of the above
Is your dog reliably house trained?*
- YES
- NO
Have you ever used potty or pee pads to house train your dog?*
- YES
- NO
Are you currently using potty or pee pads to house train your dog?*
- YES
- NO
Is your dog crate trained? Comfortable in the crate? Yes or No and give details.*
Has your dog ever exhibited any destructive behaviors while you are at home or when you leave the house? Yes or No and give details.*
Has your dog ever tried to break out of a crate? Yes or No and give details.*
Does your dog whine, growl or bark while in the crate? Yes or No and give details.*
Is your inside dog ever confined when you are home?*
- YES
- NO
If yes, where and why?
Where does your dog stay when you are away at work?*
Where does your dog sleep?*
How much time is your dog alone each day?*
Does your dog react negatively to touching/petting? Yes or No, give details*
Is your dog aggressive when people approach his/her food? Yes or No, give details*
Is your dog aggressive when people try to take his/her toy away? Yes or No, give details*
Does your dog growl when you try to move him/her off furniture? Yes or No, give details*
Does your dog attend doggie daycare? Yes or No, name of daycare*
Does your dog have a high prey drive? Yes or No, give details*
How is your dog with dogs he/she has never met before? Give details*
Has your dog injured or killed small animals? Yes or No, give details*
Please check all that apply.*
- Crate Trained
- Jumps Fences
- Destroys Bedding
- Invisible Fence trained
- None
How much alone time outside?*
Tell us about your dog's outside area*
- Conventional Fence
- Invisible Fence
- Combination
- Outside Kennel
- Patio
- Field
- Other
- No outside area
How much time do you spend playing/training/interacting with your dog(s) each day?*
Do you take your pet on outings or walks?*
- YES
- NO
If no, is it because of your dog's behavior?*
- YES
- NO
Please explain any problems during outings or walks. Nervousness, Reactive, Aggressive, Over Excited.
If yes for outings or walks, how often? daily-weekly monthly?
How long are most outings or walks?*
- 15 minutes
- 30 minutes
- 45 minutes
- 60 or more outings
- I don't take my dog on outings
- I don't take my dog for walks
What type of collar / harness do you use during walks?*
What type of leash / lead do you use during walks?*
What are your dog's favorite toys / games?*
What brand /type (wet/dry/combo) of food are you currently feeding your dog? PLEASE BE DETAILED.*
Why did you choose this product?*
How often does your dog eat each day?*
- 1 time a day
- 2 times a day
- 3 times a day
- 4 times a day
- Free feed/bowl always contains food
How MUCH do you feed your dog at EACH meal?*
Has your dog gained weight in the past three months?*
- YES
- NO
Has your dog's coat changed in the past three months?*
- YES
- NO
What negative behaviors are you experiencing?*
- Jumping up on people
- Jumping up on furniture
- Excessive barking
- Excessive chewing
- Excessive digging
- Excessive licking
- Reactive(growling, lunging, barking, spinning) towards people while on leash
- Reactive(growling, lunging, barking, spinning) towards dogs while on leash
- Reactive(growling, lunging, barking, spinning) towards people while off leash
- Reactive(growling, lunging, barking, spinning) towards dogs while off leash
- Reactive(growling, lunging, barking, spinning) towards dogs while in the crate
- Separation anxiety
- Toileting in the house
- Toileting in the crate
- Submissive urination (pees when excited or scared)
- Mouthing (puppy play biting)
- Bite history towards another dog, no medical attention needed
- Bite history towards another dog, torn or punctured skin, or medical attention needed
- Bite history towards a human, no medical attention needed
- Bite history towards a human, torn or punctured skin, or medical attention needed
- Overexcited behavior
- Counter surfing
- Demanding attention
- Resource guarding/aggression (guarding of toys or food)
- Other
- None of the above
Please Explain Above Checked Choices
SPECIFIC GOALS HERE*
Please tell us your specific expectations and goals for your dog's training. What changes in your dog would you like to see? BE VERY SPECIFIC!
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*
- 4 WEEK Behavior Modification (Jumping, Leash Pulling, Barking, Counter Surfing, Mouthing/Biting, chewing, digging, potty training issues etc), or Leash Reactivity or Minor Aggression, This program is designed for dogs with mild-moderate behavioral issues such as fear, anxiety, or aggression. Obedience/foundation work, lifestyle training geared toward correcting and preventing behavioral issues such as resource guarding, counter surfing, jumping, reactivity etc. OR young working breed dogs OR intense high energy, determined dogs, mild separation anxiety, vehicle anxiety, training with the remote system on/off leash. Also includes public access training for owners who want to be able to travel with or take their dog to public places. Board & Train HYBRID $3800
- 6 WEEK Intense Behavior Modification, Separation Anxiety, Intense Leash Reactivity, Multi Bite Incidents, Aggression Comprehensive Advanced obedience training on and off leash. Public access training for owners who want to be able to travel with or take their dog to public places. Or head strong, problem dogs or dogs with major behavioral issues including intense fear and anxiety, training with the remote system on/off leash. Board & Train HYBRID $5800
- 8 WEEK This is the best program for most dogs as it gives the Good Dog team enough time to create strong habits in your pets. It is designed for any dog in need of mild to severe rehabilitation and/or off-leash reliability. Also includes public access training for owners who want to be able to travel with or take their dog to public places. Best program for head strong, problem dogs or dogs with major behavioral issues including intense fear and anxiety, training with the remote system on/off leash. Board & Train HYBRID $8200.
GOOD DOG! COACHING REMOTE SUPPORT
- Email / Telephone Consultation & Support. 10 minutes a month is free for anyone (clients & non-clients), then $60 for 30 minutes. Clients who purchase a Board & Train Program receive 1 year unlimited 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.
SIGNATURE*

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

: Hours

Minutes

AM/PM
CAPTCHA

Navigation

Good Dog! Coaching & Pet Care Training Questionnaire – Board & Train HYBRID

Training Questionnaire Board & Train HYBRID

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

TERMS AND CONDITIONS

PICK UP/DROP OFF AGREEMENT

PHYSICAL ACTIVITY AGREEMENT

Have More Questions? Ready To Reserve? Contact Us Today!

Call Us Now! 404-422-9832 or simply fill out the form below and we will contact you! IF YOU ARE A CURRENT CLIENT, PLEASE VISIT OUR LOGIN PAGE AND CLI

Let’s Socialize

CAREER OPPORTUNITIES

Fully Bonded & Insured!

ANIMAL'S NAME	AGE & WEIGHT	BREED OR MIX	MALE OR FEMALE	SPAYED OR NEUTERED

DOG #1	DOG #2	DOG #3	DOG #4

NAME OF CLINIC	ADDRESS	CITY & ZIP CODE	STATE	PHONE

Navigation

Good Dog! Coaching & Pet Care Training Questionnaire – Board & Train HYBRID

Training Questionnaire Board & Train HYBRID

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

TERMS AND CONDITIONS

PICK UP/DROP OFF AGREEMENT

PHYSICAL ACTIVITY AGREEMENT

Have More Questions? Ready To Reserve? Contact Us Today!

Call Us Now! 404-422-9832 or simply fill out the form below and we will contact you! IF YOU ARE A CURRENT CLIENT, PLEASE VISIT OUR LOGIN PAGE AND CLI

Social Networks

Let’s Socialize

CAREER OPPORTUNITIES

Fully Bonded & Insured!