Pet Name
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Sex
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Male
Female
Breed
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Age
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Weight
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HOME LIFE Where did you get your dog, and how long have they lived with you?
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List all other people living in your home, and their level of interaction with your dog:
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List all other animals living in your home, and their level of interaction with your dog:
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HEALTH/WELLNESS Current, chronic, or prior medical conditions and prescribed treatment if applicable:
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Current, chronic, or prior injuries and prescribed treatment if applicable:
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Known allergies:
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Current feeding regimen (include brand and formula of food, daily intake, and how food is given):
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Current energy and activity level:
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BEHAVIOR Has your dog ever shown aggression toward or bitten other animals? Describe the circumstances in detail:
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Has your dog ever shown aggression toward or bitten a person? Describe the circumstances in detail:
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Does your dog ever guard objects, toys, or food from people or other animals?
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List any situations in which your dog gets over stimulated or excitable:
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Does your dog ever show signs of being fearful or frightened? If so, please describe in detail:
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Do you see any signs of separation anxiety in your dog?
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What are your dog’s favorite forms of play? Describe your interactions during play times:
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What are your main concerns with your dog’s behavior?
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List ALL other concerning, unusual, problematic, or frightening behavior your dog has displayed below:
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ADDTIONAL While training at ACS, the use of high-value rewards in the form of training treats may be necessary. Any treats used during your dog’s Training Retreat will be added to your final bill and invoiced at checkout. If you have questions about the treats we use please discuss with a team member. If there are any restrictions, dietary or otherwise that we should be aware of, please elaborate below:
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Printed Name
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Email
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Phone Number
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