Dog & Owner Profile

Owner Name __________________________________

Phone __________________________

Dog’s name _________________________________

Age __________________

Address ____________________________________

City____________________State________Zip_________

Breed _____________________Sex ______________

Vet’s name __________________________________

Phone __________________________

Prescriptions _________________________________

Date dog acquired _______________________

Where acquired __________________________

Why selected__________________________________

What do you want to accomplish?__________________

____________________________________________

Any Problems you want to work on ?_________________ ________________________________________________

Corrections you have tried.________________________

_____________________________________________

Results ______________________________________

Previous training YES or NO

If Yes When___________How Long_______________

Commands dog knows _________________________

______________________________________________________________________________

MEDICAL HISTORY

Date of first vet exam ____________________

Date of last exam ________________________

Allergies ________________________________

Seizures _____________________________

Heart disease ___________________________

Type _________________________________

Infections ____________________________________

Sight __________________________

Hearing ____________________________________

Injuries: Date(s) and Type(s)______________________ ______________________________________________________________________

Spayed/neutered ____________Date ______________

If not, owner’s stated reasons_____________________ __________________________________________________________________

Please attach a copy of Rabies Vacanation and shot records.

Other information

What is your primary goal for attending this course?

_______________________________________________

_______________________________________________

_______________________________________________

What date are you signing up for?

Start Date _____________End Date________________

Time______________

We have kind methods to help dogs relax, but some dogs are just not ready for a group environment. If your dog is reactive to other dogs or people OR fearful of the group environment, OR disruptive OR non-responsive during the second session, Guardian Pet Services reserves the right to provide Privet lesson to be taken at the end of the class. We do encourage all dogs to attend and we will only do this after every option has been used to help your dog.

By signing below, you agree that you will not hold responsible any entity or individual that instructs, assists or provides the physical location, for any injuries, liabilities, damages or losses incurred by you, your dog, your family members, guests, strangers,or other animals, before, during or after the group Classes.

Signature__________________________________

Please select your payment methods Credit Card or Check . Please make checks payable to Kim Wolfrey.      To Pay by credit card please go to our Payment Page.  Thank you.

 Paid $25 Deposit with credit card @ Guardianpetservices.com

 Paid $25 Deposit by Check mail into 25 Obrien ave Taneytown, MD 21787 Maid Payable to Kim Wolfrey

 Paid $75 by credit card @Guardianpetservices

 Paid $75 by check mail into 25 Obrien ave Taneytown, MD 21787 Maid payable to Kim Wolfrey   will bring to first class

 Paid $150 by credit card @ Guardianpetservices.com

 Paid $150 Check mail into 25 Obrien ave Taneytown, MD 21787 Maid Payable to Kim Wolfrey   will bring to first class

In-home private sessions only.  Please  Call or e-mail for appointment

Please highlight print  Dog & Owner Profile all the way to the bottom of the page, one for each dog and mail to :