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Puppy Registration Form
  1. In home training for puppies under 4 months of age.

    Items marked * are required fields.

    To help us to help you please fill in as much information as is applicable to you and your puppy. Please do not use punctuation marks or commas.

    PLEASE FILL OUT A SEPARATE REGISTRATION FORM FOR EACH DOG

  2. Your Name(*)
    Please let us know your name.
  3. Address
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  4. Suburb(*)
    The Suburb field is empty, you must fill this in to Submit the form.
  5. Post Code
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  6. Telephone(*)
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  7. Other telephone
    The Home Telephone field is empty, you must fill this in to Submit the form.
  8. Your Email (home is best)(*)
    Please let us know your email address.
  9. Puppys name(*)
    The Puppy Name field is empty, you must fill this in to Submit the form.
  10. Age (weeks)(*)
    The Puppy Age field is empty, you must fill this in to Submit the form.
  11. Breed(*)
    The Breed field is empty, you must fill this in to Submit the form.
  12. Sex(*)
    The Puppy Sex field is empty, you must fill this in to Submit the form.
  13. Weight (kilos)
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  14. At what age did your puppy come to you?
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  15. Where from?
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  16. Where did get your puppy if chosen OTHER from above?
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  17. How many adults/children live in the house?
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  18. What are the ages of any children?
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  19. What other animals (cats/dogs) live in the house?
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  20. Why did you choose this particular puppy?
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  21. To which vets surgery do you/will you usually take your puppy for a check-or vaccinations?
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  22. Has your puppy already been examined/treated by a vet?
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  23. Please explain if YES to the above question
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  24. Is your puppy on any medication?
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  25. If you answered YES above please explain.
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  26. During the working week/weekends, what is the most amount of time per day that your puppy spends without human company?
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  27. Do you use a dog crate for short term confinement?
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  28. Where is your puppy allowed when somebody is at home?
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  29. Where is your puppy kept when nobody is at home?
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  30. Where does your puppy currently sleep at night?
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  31. Is s/he is allowed to go on the furniture?
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  32. If you answered YES above explain where he is allowed to go.
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  33. What brand (s) of food do you feed your puppy?
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  34. How many times a day do you feed your puppy?
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  35. Who does the feeding?
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  36. Do you leave food out for free feeding?
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  37. What type of treats, bones or chew items does your puppy get?
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  38. How does your puppy get physically exercised?
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  39. How does your puppy get mentally exercised?
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  40. How often does your puppy get brushed and by whom?
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  41. How often does your puppy get bathed or washed and by whom?
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  42. Can all family members handle your puppy physically (brush, bathe, trim nails)?
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  43. What is your puppys reaction to the following? Men, Women, Children,Strangers, Crowds, Unfamiliar adult dogs,Unfamiliar puppies, Horses/Cows, Bicyclists/joggers.
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  44. What things does your puppy dislike the most or gets upset by?
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  45. How would you describe your puppys personality (e.g. shy, fearful, nervous)?
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  46. What undesired habits, if any, does your puppy have?
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  47. If you said OTHER to the above please explain
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  48. What things does your puppy enjoy doing most?
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  49. What games do you or your family play with your puppy?
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  50. What is your puppys favourite toy?
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  51. What is your puppys favourite treat?
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  52. How often do you currently teach your puppy new things?
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    (e.g. junior obedience, new games)
  53. If you said OTHER above please explain.
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  54. How, if at all, do you reprimand, correct or punish your puppy for unwanted behaviour?
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  55. How, if at all, do you reward and/or motivate your puppy for doing something well?
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  56. List the goals that you have for your puppy
    (e.g. to be a socially acceptable family pet, to compete in obedience or agility trials)
  57. When there are no distractions, what verbal commands, if any, does your puppy already respond to?
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  58. If you answered OTHER above please explain here.
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  59. What are the five most important behaviours you would like to teach your puppy?
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  60. Who will be responsible for teaching training your puppy?
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  61. How many minutes a day will that person be willing/able to spend helping your puppy to learn?
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  62. What do you think of the importance of being dominant or the Alpha wolf over your puppy/adult dog?





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  63. Which puppy training books do you have as a permanent reference?
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  64. Is there anything else about your puppy or your circumstances that we should be aware of:
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  65. If you said YES above, please explain
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  66. If you would like to arrange an in-home-puppy-school training session, how soon would you like it?
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  67. Which days of the week would be BEST for you?
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  68. Which days of the week would be POSSIBLE for you?
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  69. What times of the day would be BEST for you? Please choose all that apply.
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  70. We try to fit in with your preferred times but if our trainers are already committed elsewhere what other times would be possible for you?
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  71. *Appointments on public holidays incur an additional fee of $75.00
  72. Necessary legalities:

    Please note that we are unable to assist you and your puppy with in-home training unless this section has been completed

    I, being over the age of 18 years and the owner and/or the handler of the dog described in this profile form, fully understand and accept that owning and training a dog is not without risk. Therefore, in the event of any human or canine injury, illness, or accident, however caused and to whomsoever caused, I promise and guarantee at all times to hold harmless C.L.E.A.R Dog Training, its principals, owners, assistants, agents, employees, sub-contractors and clients from all liability, damage or injury to any persons, animals or property arising from or related to my dog.
    I also promise that if I do not return any of the training CDs, DVDs or books loaned to me during training then I will reimburse their cost price.

  73. Please type in your name as an electronic signature (*)
    You must fill in your name in order to submit the form.
    By entering your name, you electronically acknowledge reading and understanding the above document.
  74. Todays Date(*)

    Please enter today's date
  75. Please check that all fields marked have been completed, otherwise the form will not be sent.