Owner/Guardian Information Full Name* email* Address* Address (line 2) Address (line 3) City* State or Province* Zip or Postal Code* Phone (day)* Phone (evening)* Fax Animal's Information Animals Name* Breed/Type* Age* Height* Weight/Type* Sex* Spayed/Neutered* Yes No Workshop Information Date* Location* General Information Where did you get your animal? (e.g. breeder, pet shop, shelter, friend, etc.) How long have had him/her? What do you know about your animal's life before he/she came to live with you? How does your animal usually respond in unfamiliar situations or places? How much is your animal handled by you, and/or by others? Living Environment Describe your animal's living environment (housing, companions etc.) Behaviors Does your animal have some behavior that you wish was different? Please describe unusual behaviors even if they are not your principal concern (what and when) What have you done, if anything, to change the behavior? Has it helped? Are you usually comfortable about handling your animal in all circumstances? (please clarify) Health Please describe your animal's health and any health concerns you may have Please list vaccination history, if applicable. (this can be important in understanding some health or behavioral changes) Is your animal currently under the care of a veterinarian? and what for? Is he/she on any medication? Personality Describe your animal's personality and what you particularly like or wish was different Other Comments What are your goals for bringing your animal to this training? Other comments or items of note Signature Owner (please type name to indicate signature)
