Owner Information

How did you hear about K9Mania?

How did you hear about K9Mania

First Name *

Last Name *

Phone *

Email *

Postal code *

Address *

State *

City *

Have You Ever Owned A Dog? *

Have you Ever Trained A Dog? *

How Many Children Do You Have? *

Briefly State What You Hope To Accomplish In This Class:

If there's an additional owner you want to include please provide the Full Name and Relationship below (optional) :

Additional Owner's Full Name:

Relationship (Co-owner, Partner, Relative, or Friend)

Owner Verification

Type of Valid ID *

Other Type of Valid ID *

Upload a valid photo ID *

PNG, PDF, JPEG or JPG

Dog's Information

Dog's Name *

Dog's Breed *

Dog's Age *

How Old Was The Dog When You Acquired It? *

Gender *

Male

Female

How Long Have You Owned The Dog?

Has Your Dog Been: *

Spayed

Neutered

None of the Above

Where Did You Acquire Your Dog? *

Where Does Your Dog Sleep At Night?

Is Your Dog House Trained?

Behavior Problems Of Parents Or Littermates, if Known?

Dog's Weight *

Veterinary Information

Veterinarian

Vet Clinic

Clinic Address

Is Your Dog Current On All Vaccinations including Rabies? *

Yes

No

Vaccination Dates:

Rabies *

Bordetella/Kennel Cough *

DHLP *

Fecal Test Date (date of sample collection) *

Please List All Medications Your Dog Is Currently Taking. Please Include Heartworm, Flea and Tick Medications, etc *

Please List Any Medical Problems Your Dog Has Had: *

Behavior Information

Describe Any Previous Obediance Training: *

Level Of Success? *

What Commands Currently Work Best? *

Which Member Of The Family Has The Best Control? *

Does Your Dog Know How To Walk On A Leash? *

Yes

No

How Does Your Dog Respond To The Following Tasks?

Trimming Nails? *

Giving Pills? *

Cleaning Ears? *

Grooming? *

Bathing? *

Patting Head? *

Being Lifted? *

Rolling Over *

Tell Me About Any Correction Techniques You Have Used And Their Effect On Your Dog’s Behavior:

Time Out *

Leash Correction *

Verbal Scolding *

Noisemaker *

Water Spray *

Rollover *

Other Description. *

Behavior Problems *

jumping on people

biting or chewing objects

dig in the ground

excessive barking

howling

groaning

urinating in inappropriate places

eating feces

tail biting

tail chasing

staring

agression

Describe Unwanted Behavior In Greater Detail: *

Describe How Your Dog Reacts To The Following Times When Left Alone:

During The Day

During The Evening:

What Is Your Dog's Reaction To Your Departure?

What Is Your Dog's Reaction To Your Homecoming?

Do You Use A Crate?

Yes

No

Does Your Dog Like The Crate?

Yes

No

Does Your Dog Exhibit Any Of The Following Behaviors, and When Does It Occurs (With Men Or In The Car)

Cowering *

Ears Back *

Tail Tucked *

Retreating *

Hiding *

Excessive Salivating *

Pacing *

Please Give Additional Information Regarding Fear Or Anxiety In Your Dog: *

Describe Situations Where Your Dog Appears Fearful And/Or Aggressive: *

Do You Ever Muzzle Your Dog For Safety? *

Yes

No

Is Anyone In Your Family Afraid Of Your Dog? If So, Please Describe: *

How Does Your Dog Respond To The Following Situations?

When Approached While Eating: *

When Approached With Treat Or Toy: *

When Dog Is Scolded: *

When Dog Is Pushed Off Furniture Or Bed: *

When Dog Is Approached While Sleeping: *

To Strangers Outside Of The House: *

To People Entering House/Yard: *

To Children Or Infants: *

To Other Dogs In Your Home: *

While In Car To People Outside Of The Car:

To Other Dogs Outside Your Home: *

Ever Aggrieve To Family Members? *

Yes

No

Has Your Dog Ever Bitten A Person? *

Yes

No

Has Your Dog Ever Been Reported To Animal Control For Biting? *

Yes

No

By providing your phone number, you agree to receive text messages about updates and offers from K9 Mania Dog Training LLC. Message and data rates may apply. Read our Privacy Policy. *