Paws Along the River Humane Society Dog Training Registration Form


Date __ /__ /_____ Breed ____________________________ M / F Age _________
Owner ___________________________________ Dog’s name ________________
Address ________________________________________ Phone _____ - ________
Email Address ________________________________________________________
Current Rabies Vaccine? Yes / No   Veterinarian _____________________________
Bordetella? Yes / No
Common behavioral issues (please check all that apply to your dog)
  House soils   Chews   Jumps up   Doesn’t come
  Fights   Barks   Pulls on lead   Shy
  Digs   Aggressive (Provide brief history of behavior. Use back if necessary)
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Other problem notes ________________________________________________________
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Corrections given to date ____________________________________________________
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Age of dog when obtained _________ From _____________________________________
Litter behavior ____________________________________________________________
House training method ______________________________________________________
Other training _____________________________________________________________
Have you attended training classes before? ____ Where _____________________________
Is this dog a house pet? ________ Exercise schedule _______________________________
Goals for class ____________________________________________________________
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List any medical concerns ___________________________________________________
Dog’s Medications ________________________________________________________
Diet ___________________ Feeding schedule __________________________________

Family data:   Adults in household ______   Children in household ___________
Occupations ______________________________________________________________
Other pets _______________________________________________________________
Previous pets _____________________________________________________________

IN CASE OF EMERGENCY PLEASE CONTACT:

Name ___________________   Phone number _____ - ________

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 Signature (Parent or Guardian if under 18)

__ /__ /_____
 Date
Logo for Paws Along the River Humane Society   Paws Along the River Humane Society
212 Elm Street
Warren, Pa. 16365