New client intake · Loyal Loop Dog Training

First name *

Last name *

Email *

Phone *

Street address

City

State

ZIP

Emergency contact

Emergency phone

How did you hear about us?

Dog's name *

Breed (or best guess)

Sex

Birthdate (approx.)

Weight (lbs)

Spayed or neutered

Rabies vaccination expires

Required before any group class. We'll ask for a copy at the first session.

Veterinarian

Other health notes

This dog has bitten a person or another animal

If yes, what happened?

We are not here to judge. We need this to keep everyone — including your dog — safe.

Known triggers

What does success look like in 90 days? *

Previous training

Household

Food & motivation

Program you're interested in

When are you generally available?

I've read the training agreement, cancellation policy, and liability waiver and agree to them. *

You may use photos or video of my dog for training examples and social media.

Tell us about your dog