EmailMe Form - Tails of Success Private Training Intake Form

Name

First Last

Name (owner #2)

First Last

Phone *

### - ### - ####

Phone (owner #2)

### - ### - ####

Email *

Email (owner #2)

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

How did you hear of us? *

Please confirm my reservation via *

I will call to schedule

My appointment is already set

Dog's Name

Breed

Age

Date of birth (approximate is okay) *

Vet Hospital *

Weight *

Gender

Male, neutered

Female, spayed

Male, unneutered

Female, unspayed

Color

I give permission for Tails of Success to share behavior information with my vet, including my dog's assessment, treatment protocol and progress notes. *

Yes

No

What type and brand of food does your dog eat? *

Food allergies?

Please outline any injuries, illness or medical history on your dog.

Please describe the PRIMARY reason you are seeking training. *

Please outline any additional areas of concern you would like to address.

Please list the names and ages of all members of the household. *

Has your dog ever bitten anyone? Please explain: *

How does your dog react to strangers coming into the home? *

Please describe any situations in which your dog exhibits aggression:

Are you considering rehoming or euthanasia for this dog? *

No

Rehoming

Euthanasia

Not sure

Please explain:

Is there anything else we should know about your dog?

What is your favorite thing about your dog? *

Please outline any previous training you have done with this dog:

I prefer to do my lessons: *

In my home

On site at Tails of Success

Wherever the trainer feels is best

Please add any necessary info about scheduling:

Payment is due in full at the time of scheduling for all appointments. Cancellation policy is as follows: 20% fee to cancel/reschedule for 7 or fewer business days notice. 50% fee for 3 or fewer business days. Charged in full with less than 1 business day notice. INITIAL: *

I understand and accept that I am responsible for all actions of myself, my guests, and my dog/s while on Tails of Success property. Therefore, I release Tails of Success and their landlord, employees, instructors and assistants of any and all liability for injury to myself, my guests and my dog/s. I accept full legal and financial responsibility should my dog injure any person or dog while on Tails of Success property. Initial: *

Thank you for choosing Tails of Success for your behavior needs!

Please give us a call at 585-360-0030 to schedule your session with our trainer.