Student Profile - South Austin Dog Center
Meet the Trainers
Meet the Trainers
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In preparation of your consult, please complete our intake form so we have a better idea on how to assist you and your dog.
The Profile could take 10-30 minutes to complete. Only "Sent" information is saved. Refreshing or closing your web browser will result in all information being lost, so please complete all 7 sections in one sitting. Thank you!
First, may we please have your contact information, be sure to fill out all areas.
Your Information - Section 1 of 7
Daytime Phone Number
Evening Phone Number
Emergency Contact Phone
Repeat Your Email*
TX - Texas
Dog Information - Section 2 of 7
Now let's get some basic information about your dog(s)!
Does your dog have a nickname?
Male - Neutered
Female - Spayed
Male - Intact
Female - Intact
From where did you aquire your dog?
Shelter - Other
How long have you had this dog?
Age of dog when acquired
If your dog was previously in foster care, may we contact the rescue to obtain further background information on the dog?
Will you be filling out another form for another dog?
No - We're a 1 dog home
No - The other dog is perfect
Home Information - Section 3 of 7
home and daily routine
Please list all members of the household and their ages:
Are there any other animals in the home?
If so, please list their names, ages, species, and breed (if applicable)
Please indicate the approximate amount of time your dog spends:
Crated or Tethered
Does your dog settle in a crate?
I don't know
About how long per day do you:
Walk your dog on leash
Play with your dog
Let your dog run off leash
Medical History - Section 4 of 7
Before we can allow your dog to come to our facility, we must make sure s/he is current on our required vaccinations.
Does this dog have any physical limitations or medical issues?
Any known food allergies?
If so, please describe below:
What is your dog's regular food?
How much does your dog eat per day?
How often are meals provided?
Free Feed (always available)
Who is your regular veterinarian?
Vet's Phone Number
Would you like to attach your dog's vet records now?
I'll send them seperately
I'll have my vet send them
If yes, please attach your dog's most recent medical file(s). You can attach up to 5 files if necessary. A picture is ok.
Behavioral History - Section 5 of 7
Has your dog ever bitten or injured another dog or person?*
If so, did the injury require medical attention?
If so, please describe the nature of the injury, what was happening at the time, who was involved, and anything else you remember and believe to be important:
Please check any which applies to your dog
Not Good w/ People
Not Good w/ Dogs
Please briefly describe anything you've checked
Training Goals - Section 6 of 7
Expectations and Goals
What are the top 3 things you love about your dog?
The #1 Thing I LOVE about my dog is:
The 2nd Thing I LOVE about my dog is:
The 3rd Thing I LOVE about my dog is:
What 3 things do you wish you could change?
The #1 Thing I wish we could change is:
The 2nd Thing I wish we could change is:
The 3rd Thing I wish we could change is:
What, specifically, do you hope to accomplish with this training?
Almost finished! - Section 7 of 7
Is there anything else you think we should know?
Please read and agree to the following Waiver of Liability and Informed Consent Release*
I, the undersigned, have enrolled myself and my dog in dog training classes, private consultations, workshops or other related activities ("Classes") offered by South Austin Dog Center, LLC ("SADC"). By signing hereunder, I certify that I have been informed and understand that there is always some unavoidable risk of injury involved when working with animals, especially animals with behavioral issues. I acknowledge that dogs can be inherently difficult to control and that not all dogs will be under control at all times resulting in the possibility of injury to myself, my dog, my family members, or third parties. Additionally, I have had full opportunity to discuss all concerns I have about the foregoing risks with SADC and its authorized representatives. I have also made all inquiries and investigations to my satisfaction related to such risks, including, but not limited to, an examination of the training area (if applicable). I hereby accept and assume, without reservation, all risks associated with my participation in the Classes, including, but not limited to: the risks of any and all injuries to myself, my dog and any of my family members or third parties who may attend; the risks that my dog may cause injury to other persons and/or dogs involved in the Classes; and the risks that saliva, water, food, snow and/or other debris may be present in the training area. I have read and understand SADC’s Training Facility Operating Policies (next page), and agree to abide by them to the extent applicable. As lawful consideration for participating in the classes, I, for myself, my heirs, executors, administrators, legal representatives, successors and assigns (the “Releasing Party”), hereby waive, release, discharge and agree not to sue and to indemnify, defend and hold harmless SADC, and Howl N Woof Dog Daycare and their members, managers, agents, and employees (the “Released Party”) from any and all injuries, losses, claims and damages to any person or persons of any nature whatsoever, including claims arising from the Released Party’s own negligence, and all costs associated therewith, including attorney’s fees, court costs and consultant fees, arising from my participation in the Classes. This Waiver of Liability & Informed Consent Release shall be legally binding on the Releasing Party. Should the Releasing Party assert a claim to the contrary to what I have agreed to in this Waiver of Liability and Informed Consent Release, the claiming party shall be liable for all expenses (including attorney’s fees, court costs and consultant fees) incurred by both the Releasing Party and the Released Party. No waiver or modification of any provision herein shall be valid unless expressly agreed to in writing by both the Released Party and the Releasing Party. I hereby consent to my dog being the subject of the photographs and/or audiovisual recording and authorize SADC to cause the same to be exhibited for educational purposes as still photographs, transparencies, motion pictures, television, video or other similar media. I hereby release SADC from any and all claims for damages for libel, slander, invasion of privacy or any other claim based on use of the above-described material(s). Every provision herein is intended to be severable. If any one or more of the provisions herein is found to be unenforceable or invalid, that shall not affect the other terms and provisions hereof, which shall remain binding and enforceable. I represent that I am at least 18 years of age.
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