New Client Form

Name *

First Name

Last Name

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Vet Office Phone Number *

(###)

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Does your dog have any allergies? *

Yes

No

Does your dog have any behavioral concerns? *

Dog Reactivity

Human Reactivity

Dog Aggression

Human Aggression

Resource Guarding

Fearful/Shy in New Enviroments

Small Animal Reactivity (cats, rabbits, squirrels, ect)

No Behavioral Concerns

Other

What training equipment have you used with this dog? *

Flat Buckle Collar

Back Clip Harness

Front Clip Harness

Head Halter/ Gentle Leader

Slip Leash/ Slip Collar

Prong/ Pinch Collar

E-collar/ Remote Collar

Invisible Fence

Bark Collar

Muzzle

Other

What equipment are you still regularly using now? *

Flat Buckle Collar

Back Clip Harness

Front Clip Harness

Head Halter/ Gentle Leader

Slip Leash/ Slip Collar

Prong/ Pinch Collar

E-collar/ Remote Collar

Invisible Fence

Bark Collar

Muzzle

Other

Has your dog ever bitten another dog? *

Yes

No

Has your dog ever bitten a human? *

Yes

No

Do you let your dog meet other dogs while on leash? *

Yes

No

Do you understand that training a dog requires practice and consistency from all the members of the household? *

Yes

No

Do you understand every dog is different and no training result is ever guaranteed? *

Yes

No

By agreeing you understand that your dog must be current on age appropriate vaccines and preventatives and stay up to date for duration of their training with Nerdy Dog Training. *

Required vaccines include- Rabies, parvovirus, canine distemper, and bordetella (kennel cough). Puppies must have at least 2 rounds of puppy vaccines and be up to date on age-appropriate vaccines. Proof of appropriate titer tests will also be accepted as proof of vaccination.

I agree

By agreeing you understand that if you must cancel or reschedule an appointment, you must do so with at least 24-hour advance notice. Failure to do so will result in forfeiture of that lesson or eval. *

I understand

Are you familiar with the pricing of our services? *

If not, we recommend going through the information on our website about pricing.

Yes

No

What service(s) are you interested in? *

Puppy Class

Basic Manners Class

Intermediate Class

2 Week Puppy Board and Train

4 Week Board and Train

6 Week Board and Train

8 Week Board and Train

Service Dog Training

I'm not sure