DOG TRAINING CLIENT INTAKE FORM TEMPLATE RIOS | 44 prompts to customize Business name: ____________________ Form version/date: ____________________ Business contact and privacy notice: ______________________________________ FOR THE BUSINESS: Remove any prompt your service does not need. Store completed forms privately. Explain access and retention to the client before collecting answers. FOR THE CLIENT: This records your report for professional review. It does not diagnose your dog, enroll you in a service or grant media or third-party contact permission. The business must collect any needed authorization separately. CLIENT AND HOUSEHOLD Know who is participating, who can make decisions and what daily life actually looks like. 1. Primary client name, email, phone and preferred contact method Answer: ________________________________________________ 2. Home address or service area, when relevant to delivery Answer: ________________________________________________ 3. Other adults, children and regular visitors in the household Answer: ________________________________________________ 4. Who handles the dog and who will attend training Answer: ________________________________________________ 5. Other animals in the home and their usual interactions Answer: ________________________________________________ 6. Accessibility, language or communication needs Answer: ________________________________________________ DOG PROFILE Create one reliable identity for the dog before notes begin accumulating across messages and systems. 7. Call name and registered name, if different Answer: ________________________________________________ 8. Approximate birth date or age Answer: ________________________________________________ 9. Breed or best-known mix Answer: ________________________________________________ 10. Sex and spay or neuter status, if relevant Answer: ________________________________________________ 11. How long the dog has lived with the household Answer: ________________________________________________ 12. Where the dog came from and known prior-home context Answer: ________________________________________________ GOALS AND SUCCESS Turn a broad request such as “better behavior” into observable priorities the trainer can review. 13. The three changes the client most wants help with Answer: ________________________________________________ 14. Where and when each concern usually occurs Answer: ________________________________________________ 15. What a successful outcome would look like in daily life Answer: ________________________________________________ 16. Important dates, events or deadlines Answer: ________________________________________________ 17. Activities the client wants to enjoy with the dog Answer: ________________________________________________ TRAINING HISTORY AND CURRENT ROUTINE Avoid repeating a failed plan without understanding what was tried, how consistently and in which context. 18. Prior classes, private training or board-and-train programs Answer: ________________________________________________ 19. Methods, cues and equipment currently in use Answer: ________________________________________________ 20. What has helped, what has not and what the client stopped using Answer: ________________________________________________ 21. Typical weekday and weekend routine Answer: ________________________________________________ 22. Exercise, enrichment, rest and alone-time patterns Answer: ________________________________________________ REPORTED BEHAVIOR AND SAFETY CONTEXT Preserve the client report as a report, then let the professional decide what must be clarified or observed. 23. Situations, people, animals or handling that concern the client Answer: ________________________________________________ 24. What the client observes before, during and after the behavior Answer: ________________________________________________ 25. Frequency, duration, distance and recovery time Answer: ________________________________________________ 26. Any bite, snap, fight, escape or injury history, including approximate date and context Answer: ________________________________________________ 27. Current management measures such as gates, crates, leashes or separation Answer: ________________________________________________ 28. Immediate safety concern or upcoming unavoidable exposure Answer: ________________________________________________ HEALTH AND CARE CONTEXT Surface information that may affect participation while keeping veterinary decisions with veterinary professionals. 29. Veterinary practice and emergency contact information Answer: ________________________________________________ 30. Known diagnoses, pain, mobility, sensory or dietary considerations reported by the client Answer: ________________________________________________ 31. Current medication and prescribing instructions relevant to service Answer: ________________________________________________ 32. Allergies or adverse reactions reported by the client Answer: ________________________________________________ 33. Vaccination or facility-document requirements Answer: ________________________________________________ 34. Recent health or behavior change that may warrant veterinary follow-up Answer: ________________________________________________ SERVICE FIT AND LOGISTICS Confirm that the requested format, timing and participation expectations match what the business can deliver. 35. Preferred service format, location and availability Answer: ________________________________________________ 36. Travel, parking, access or facility considerations Answer: ________________________________________________ 37. Budget or program range the client is prepared to consider Answer: ________________________________________________ 38. People who must approve scheduling or purchase Answer: ________________________________________________ 39. Referral source and what led the client to inquire now Answer: ________________________________________________ ACKNOWLEDGMENT AND NEXT STEP Make submission, professional review and any later agreement distinct events rather than treating an inquiry as consent. 40. Confirmation that the information is complete to the client’s knowledge Answer: ________________________________________________ 41. Permission to contact the named veterinary or referring professional, if needed and separately authorized Answer: ________________________________________________ 42. Optional media permission kept separate from service documentation Answer: ________________________________________________ 43. Client questions or information not covered above Answer: ________________________________________________ 44. Submission date and person completing the form Answer: ________________________________________________ STAFF REVIEW - complete separately after reviewing the client report Reviewer and review date: _________________________________________________ Questions requiring clarification: ________________________________________ Service-fit decision / referral / next step: _______________________________ Next action, responsible person and due date: ______________________________ Adapt this operational starting point to your service. It is not a service agreement, waiver, diagnosis or treatment plan. 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