Dog Training Questionnaire

All questions marked with the red asterisk must have an answer in order to submit your information.

First Name *
Last Name
Address *
City *
State *
Zip Code *
Dog's Name *
Primary Phone Number *
Secondary Phone Number *
Email Address *
What breed(s) is your dog? *
What is your dog's gender? *	Male Female
Is your dog spayed/neutered? *	Yes No
What is your dogs date of birth? *
What veterinarian does your dog go to? *
Does your dog have any medical concerns, limitations, or allergies? *
What are the top 3 goals you hope to achieve through training? *
Have you ever been through training before? *	Yes, with this dog Yes, but with a previous dog No
What are some problematic behaviors you would like to work on? (select all that apply) *	Jumps up Snatches food (from hands/counter) Barks excessively Destructively chews Not Housebroken Growls Eats non-food items/toys Easily stressed/nervous Breaks out of the crate Runs away/doesn't come when called Bolts out the door Digs Marks indoors Unruly when guests come over Submissive or excitable urination Separation anxiety Pulls on the leash Mounting/humping New dog
The applicant/potential adopter and his/her spouse, heirs, executors, personal representatives and assigns agree(s) hereby releases Helping Hounds Dog Rescue and its directors, officers, employees, agents, representatives, contractors, volunteers, successors and/or assigns from any liability arising from any behavior or actions of the dog including, but not limited to, biting, chewing, jumping, pulling and destruction of personal property. *