Training & Behaviour Intake Form

Service and your details

Which service is this intake for? * Life SkillsPractical everyday skills in a small group. Pathway to Life SkillsIndividual support to get started before joining Life Skills. Reactivity SupportIndividual support for barking, lunging, freezing or overwhelm. Puppy Life SkillsFive-week puppy school for puppies aged 8–18 weeks.

So I can contact you about your intake.

Your full name * Mobile number * Email address *

Your dog

Dog's name * Date of birth (approximate is okay) * Breed or mix (best guess is fine) *

Training goals

What would you most like help with? * When do these behaviours usually occur? *

Behaviour screening

Does your dog show any of the following? * Barking at other dogs Lunging at other dogs Barking at people Lunging at people Reactivity to movement, such as cars or bikes Difficulty disengaging once aroused Becomes overwhelmed in busy environments None of the above

Please describe anything selected above. Enter “No” if none. *

How does your dog behave around other dogs? * Calm and neutral Excited but manageable Easily over-aroused or difficult to disengage Avoidant or shuts down Reactive, such as barking or lunging

Can your dog settle and recover after becoming excited or overwhelmed? * Yes Sometimes No

Daily life and environment

What does a typical day look like for your dog? Include time alone, other animals and household members. * What physical and mental exercise does your dog typically get? *

Where does your dog spend most of their time? * Indoors Outdoors Both

Training history

Has your dog done any previous training or classes? * Yes No

If yes, what kind? What has worked well for your dog so far? * What hasn’t worked well for your dog so far? *

Rewards and health

How food-motivated is your dog in new or distracting environments? * Very motivated Sometimes interested Rarely interested Unsure

What rewards does your dog respond best to? * Any injuries or medical conditions? Enter “None” if there are none. * Is your dog currently taking any medication or supplements? Enter “No” if not. * Has allergies

Safety and final details

Has your dog ever bitten, attempted to bite, snapped at or injured a person or another animal? If yes, provide details. Enter “No” if none. * Emergency contact: name and phone number * Most recent vaccination certificate (optional, PDF, JPG or PNG; maximum 8 MB)

Safety and information acknowledgement

I confirm that the information provided is complete and accurate to the best of my knowledge. I will tell The Operant Dog about relevant changes to my dog’s health or behaviour. I understand that dog training involves inherent risks and agree to follow reasonable safety instructions during sessions.

I have read and accept this acknowledgement. *

Media permissions (optional)

These permissions are separate and optional. Leaving either box unticked will not affect your enrolment or support. Other identifiable adults must give their own permission; a parent or guardian must consent for a child.

I consent to The Operant Dog using photos or videos of my dog for education and marketing, including its website and social media. I consent to The Operant Dog using identifiable photos or videos of me for education and marketing, including its website and social media.

By submitting, you agree that The Operant Dog may collect and use this information to assess suitability and deliver training services. See the Privacy Policy.

Tell me about you and your dog