Name *

First Name

Last Name

Mobile Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Sex *

Female

Male

Neutered/Spayed? *

Yes

No

Past Training? *

Yes

No

A little

Please select the type of training methods that have been practiced with your dog *

Positive Reinforcement: Food - toys - praise

Punishment: Corrective Equipment or Alpha Based Training

Mixed: Some Treats Some Correcting

Does your dog have any bite history towards another animal? *

No bite history

Minor snap(s): no contact

Minor snap(s): no blood - some bruising

Minor bite(s): some blood and bruising

Bite: blood but no stitches

Bite: stitches required

Bite: severe injury caused

Does your dog have a bite history towards a person? *

This does NOT include puppy nipping

No bite history

Nip but no contact

Bite with no broken skin or damage

Bite with some bruising

Bite with bruising and a scratch

Bite with a scratch and bleeding

Bite with bleeding and a tear

Bite with bleeding and a tear