Basic Client Information Emergency Information Basic Dog Information Dog Details Pack Walk Information Client Info Emergency Dog Info Dog Details Pack Walks Name First Name Last Name Date Date Address Address Postal Code Contact Email Cell Phone Work/Home Phone Emergency Contact First Name Last Name Phone Permissions In the event of an emergency do we have permission to bring your dog to Central Animal Hospital? Yes No Do you have Pet Insurance? Yes No Have you filled out and submitted a waiver form? (If not, please make sure you do before the date of your pack walk) Yes No Who is your Pet Insurance provider? (If applicable) Please include any other medical or emergency information. Name Dog Name Birth Information Age Birthday Sex Female Male Breed Current Health Weight Are vaccinations up to date? Yes No Is your dog spayed or neutered? Yes No Does your dog have any allergies? Behaviour and Training Has your dog had professional training? Yes No 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? Yes No Sometimes If walked in a designated off-leash area, can your dog be off leash? Yes No Does your dog ever dart out of open doors or try to run away? Yes No Sometimes Rarely Does your dog exhibit aggression towards other dogs? Yes No Sometimes Rarely Does your dog exhibit aggression towards people? Yes No Sometimes Rarely Has your dog had a Thumbs Up evaluation, come out for a community walk, or taken part in other services? Yes No Please include any other helpful information. Pack Walk Details How many times per week would you like your dog to go on pack walks? 1 2 3 4 5 Which days would you like? What is your desired start date? If you are signing up for one pack walk, please indicate the specific date. One last thing... How did you hear about Thumbs Up Dog Training? SHOW SUMMARY Some required Fields are emptyPlease check the highlighted fields. Submit Previous Step Next Step
