Basic Client Information

Emergency Information

Basic Dog Information

Behaviour and Training


  • Client Info
  • Emergency
  • Dog Info
  • Behaviour
  • Training


First Name

Last Name





Postal Code



Cell Phone

Work/Home Phone

Emergency Contact

First Name

Last Name



In the event of an emergency do we have permission to bring your dog to Central Animal Hospital?

Have you filled out and submitted a waiver form? (If not, please make sure you do before the date of your training session)


Dog Name

Birth Information





Where did you get your dog?

Please name the breeder/rescue shelter (if applicable)

How old was your dog when you got them?

Please include any helpful comments or notes.

Current Health


Are vaccinations up to date?

Is your dog spayed or neutered?

Does your dog have any allergies?

What type/brand of food does your dog eat?

Does your dog have any medical conditions?


Has your dog had professional training?

What level of training has your dog completed? (If applicable)

What company did your dog train with? (If applicable)


Does your dog come when called?

Does your dog tend to chase cats, squirrels, deers, birds, etc.?

When give the chance, does your dog bolt out the door or away from you?

Does your dog bark profusely when someone comes to the door?

Does your dog calm down after visitors come in?

Is your dog calm at home when you go out?

Does your dog snap or growl when being touched or groomed?

Is your dog fearful of people or dogs?

Has your dog ever been attacked?

Has your dog ever attacked a dog or person?

Does your dog exhibit general aggression on leash?

Does your dog exhibit aggression towards other dogs?

Does your dog exhibit aggression towards people?

Does your dog exhibit aggression when food or toys are involved?

Is your dog crate trained?

Please include any details or information you think would be helpful.

Training Goals

What are the issues you would like to address?

What are the goals you would like to accomplish through training?

If you know the training package you want, please select from the list below.

Please provide any other information, questions or concerns you have.

One last thing...

How did you hear about Thumbs Up Dog Training?