Barker Behavior - Dog Training In Chicago
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Private Consultation Behavioral History Form
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Email Address:
Dog's Name
Referred by
Breed:
Dog's Age:
Dog's Sex: Male Female
Spayed or neutered? Spayed Neutered
Other pets in house:
Other people in the house:
Veterinarian:
Medical problems:
Has the dog ever bitten/injured anyone? If yes, describe (please describe in detail how many bites your dog has inflicted on another dog or human and the severity of damage):
Where is the dog from/how long together:
Housebroken? Yes No
Crate trained? Yes No
Where does the dog sleep?
Brand of food:
Fed how many times a day?
Food restrictions/allergies?
Has the dog had any previous training? If so, describe (include cues he knows):
Daily exercise:
Reason for Consultation (please be as detailed as possible so we can make the most of our session):
What have been doing to remedy behavior/training issue:
Please list a few preferred dates and times (be specific, instead of 'evening' say '5pm or later'):

Please initial each agreement(required):
I understand that my appointment time is secure once I submit a credit card to Barker Behavior, Inc.
I understand if I cancel my in-home consultation within less than 24 hours of the appointment Barker Behavior, Inc. will charge my card a $50 cancellation fee
I understand if parking is not available Barker Behavior, Inc. will ask that I cover the parking fees.
I understand and have read the travel fees, for in-home sessions more than 5 miles from the Barker Behavior office.
Barker Behavior, Inc. will endeavor to create as safe an environment as possible for the training and boarding care of my dog and will offer only sound, safe, and responsible training, care, and post-boarding training instructions. However, I recognize that Barker Behavior, Inc. is not responsible for any unintentional errors, omissions, or incorrect assertions. I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service. Further, I am and will remain responsible for the actions of my dog at all times and I hereby agree to indemnify and hold harmless Barker Behavior, Inc. of any and all claims of injury, expense, costs, or damages caused by the actions of my dog while under Barker Behavior, Inc. care and under my own care as a result of following training instructions. I have been told by Barker Behavior, Inc. and understand the inherent risks in owning a dog, including but not limited to the risk of dog bites to myself or others.

***We do require a credit card to secure the appointment on our trainers’ calendars. Thanks so much!***

 

 

 

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