Good Dog! Coaching & Pet Care One on One In Home Training Questionnaire

    1/1 Training Questionnaire
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    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?
    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?
    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 YOU DESIRE

    PLEASE CHECK THE SERVICE RECOMMENDED BY YOUR TRAINER

    GOOD DOG! COACHING REMOTE SUPPORT

    TERMS AND CONDITIONS

    Payment is due in full at the end of the first training session. Accepted forms of payment are Cash, Check or Credit/Debit Card. When paying by credit card a small 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 chosen program. 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 Sessions(s) included with the Good Dog! Full Training Program and the Good Dog! Super Dog! shall be completed with in 90 days of the starting session. The Good Dog! Back to Basics and Good Dog! Jump Start Programs shall be completed with in 60 days of the starting session. All Unused Sessions are forfeited at the end of the 60 day period. No Refunds of any kind for unused sessions after the completion of the first session. 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.

    Clients that contact us to cancel or reschedule appointments within 24 hours of a scheduled appointment will be charged a rescheduling fee of $100. A No show to a scheduled appointment will result in forfeiture of that session

    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 control normal household distractions such as television, telephone interruptions, children or foot traffic, or to provide a quiet distraction-free area for the sessions at per Good Dog! Coaching representative's requests.

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