Dog Training Intake FormCompleting this form will assist our trainers by providing valuable information to help us with training recommendations for your dog. Owner's Name(s)* Today's Date Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d’IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor-Leste)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonThe GambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Email* Cell Phone Number* Emergency Contact Name* Emergency Contact Cell Phone* Which Training Program Are You Signing Up For?* Puppy Head-StartLevel 1 ObedienceLevel 2 ObedienceLevel 3 ObediencePuppy Day SchoolStandard Day SchoolEnrichment Day SchoolRefresher TrainingPrivate Training at Bliss Dog's Name* Dog's Predominant Breed* Dog's Gender* MaleFemale Dog's Age Where did you get your dog from* BreederLocal Shelter / RescueFamily / FriendFound Has your dog had previous training?* YesNo What training has your dog received previously?* Where did this training occur?* Do you feel your dog suffers from separation anxiety and why do you feel this way?* Do you feel your dog demonstrates anxious and nervous traits and behaviors? Why do you feel this way?* Has your dog ever displayed aggression to humans or animals?* Yes to HumansYes to AnimalsYes to both Humans and AnimalsNo Has your dog ever bit another human?* YesNo If Yes, did this bite require stitches? YesNo Tell us some specific things with your dog that you are struggling with?* Is there anything unique or odd about your dog or his/her behavior that we should know about?* Does your dog have any food or seasonal allergies we should be aware of?* Is your dog currently on ANY medication? If so, please tell us what it is and to treat what issue.* If you have a dog that has long hair or hair that is easily matted (Doodles, Poodles, etc.),we recommend that you groom to a shorter haircut prior to training. Your dog will be with us playing, learning and having fun and sometime the long hair can mat.* Got it, no problemI'll get it cut prior to arrivalI'll take care of it after training Is your dog an escape artist? Can he EASILY jump or scale fences?* Yes - EasilyNo IF Boarding, select which BOARDING ADD-ONS you would like your dog to have while he/she is with us. These are optional upgrades to his/her training stay with us.* Brush Out ($10)One-on-one ($10)Bedtime Stories ($10)Frozen Peanut Butter Kong ($5)Pup Pastry ($4)All Natural Marrow Bone ($5)None How often would you like the above selected add-ons given to your dog while training with us? DailyEvery Other DayBi-WeeklyWeekly Would like to add additional OFF-SITE Field Trips to your dog's training to test and proof his learning at other locations such as Home Depot, The Square, etc? These trips are $75 each. No, ThanksOne Additional TripTwo Additional TripsThree Additional TripsFour Additional Trips If doing a Board n Train program, would you like to* Full Service BathNail Trim ($15)Blueberry Facial ($5)Teeth Brushing ($7)All Over Makeover - Full Haircut ($50+)Haircut at End of Stay - Spa TrimHaircut at End of Stay - Outline TrimDeshed Service ($10+)None How much playtime with other dogs of similar size and temperament (daycare) would you like your dog to have while boarding with us? All Day PlayHalf Day PlayShorter Session AM/PMNo Daycare Time, Just Potty Breaks Has your dog passed a Temperament Test to evaluate social play skills within the last six months?* YesNo Check Each Box To Acknowledge Info* Select AllProgress updates will occur on Mondays and Thursdays each week your dog is with us. This will be done via text.Visits are allowed but these need to be scheduled with your assigned trainer.Please do not ask for daily updates. When we average 10-12 dogs each day, this can be very time consuming and slows our training down.When appropriate, we will send pics of your dog working.Your trainer will initially reach out to you via text to introduce themselves. This is done on Mondays and Thursdays.Full Payment Will Be Due at Check-Out for Board and Training Packages Full payment will be due at booking for all Day School services. How did you hear about our training services?* From Friend / AcquaintanceVet ReferralFacebook AdGoogle SearchDrove by Location