Name
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First Name
Last Name
Email
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Phone
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(###)
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####
Is it ok for us to text you?
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Yes
No
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Where did you hear about us?
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Dog(s) Name
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Dogs Age or Estimated Age
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Where did you obtain your dog(s)? If Rescue or Breeder, please list name
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Dog(s) Breed
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Have you owned this breed(s) before? If no, please explain why you decided on the breed.
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Dog(s) Weight
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Is your dog(s) spayed/neutered
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Is your dog on any medications? If so please list.
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What do you use for Flea and Ticks?
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When is your dog due for Rabies?
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Yes
No
Not required
Who is your Veterinary? Please list name and location.
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What brand of dog food are you feeding?
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Are you willing to learn more about healthly food choices for your dog?
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Yes
No
Has you dog had any formal training? If so, please state business name.
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Do you use any type of training tools with your dog(s)? If so, please list.
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Examples: Harnesses, Haltis, Prong Collars, Slip lead, Shock collars, treats only
Are you agaisnt using certain training tools? If so please list.
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Is your dog(s) crate trained? If no please state why/where your dog stays when unsuprvised.
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DO YOU AND YOUR DOG VISIT DOG PARKS? (Please note we do not believe in dog parks, and to be apart of our program you have to agree to not visit them.This is to ensure the safety of your dog, and to protect your training investment. Please Type, Agree or Disagree. If you disagree, please type why.
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Has your dog done any of the follow actions?
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Please list any concerns and issues you are having with your dog. If none type N/A
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With new dogs, how does your dog act?
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Release of Liability I hereby waive any and all claims or actions that I or my guardians or representatives may have, from any and all personal injury to myself, my dog, children in charge, or harm to property or person caused directly or indirectly , through action or inaction of self or others, by acts that might occur in dog training classes, any other format of training activities or secondary training without trainer present or engaged. I agree to indemnify Soul Healing Canine and affiliates from any and all claims by myself, member of family, or any agent while within training facilities, within my home property, or in the general public as a result of any action or inaction, of either my dog or any other.
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(Please initial to confirm agreement)
Please bring a copy or send proof via text of your dog(s) shot records. If you plan on taking advantage of our Boarding/Board and Train, please type up a statement giving AnnMarie Deen permission to make veterinary choices during the time of stay and or you can call your veterinarian at the time of issue letting them you are out of town and that AnnMarie Deen has permission to bring your dog in.
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Do you understand that our In-Home Consult has a fee of $100.
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Please note, due to our location and the lack of Emergency Vet options in Cleveland and surrounding, our travel time is at least 50mins + to have your dog seen after hours. Please know though we will do everything we can in that moment to seek the best care possible. Please state who to contact in the event of an emergency if you cannot be reached: (If you do not have an option that's ok, we will do what we feel is in the best option until you are reached.)
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Emergency Contact Info (If none or this does not apply to you please put N/A) Please note this is what I would refer to if there was some type of Emergency during training time with you and or while your dog is with me.
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