New Client Form | UpSwing K9 Behavior

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Are you ready to take the leap?
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Please fill out the new client intake form below!
Form will return to blank when completed.

We respect your privacy and are committed to protecting your personal information.
We will never share your data with third parties or sell your information.

First Name

Email

Last Name

Phone

Address

Dog's Name

Dog's Age, Sex, Breed

Is your dog spayed/neutered?

How long have you had your dog?

How old was your dog when you got them?

Where did you get your dog?

What are your main concerns with your dog?

What are your ultimate training goals?

Veterinarian name

Veterinarian Phone Number

Do you authorize Upswing Canine Behavioral Services to contact your vet for further information or to discuss your case? *

YES

NO

Is your dog up to date on all vaccines? *

YES

NO

Medical History - including any existing conditions your dog may have:

Current Medications/Supplements/Preventatives:

What food does your pet eat?

What is their feeding schedule?

Does your dog display any anxious/fearful body language or behaviors? *

YES

NO

If YES, please describe:

Does your dog display any signs of separation anxiety? *

YES

NO

If YES, please describe:

Does your dog display any resource guarding or aggression with other ANIMALS? *

YES

NO

If YES, please describe:

Does your dog display any resource guarding or aggression with PEOPLE? *

YES

NO

If YES, please describe:

Has your dog ever bitten another ANIMAL? *

YES

NO

If YES, please describe in detail the number of times, situation surrounding the bite and the severity:

Has your dog ever bitten a PERSON? *

YES

NO

If YES, please describe in detail the number of times, situation surrounding the bite and the severity:

Has your dog ever attended group classes or private classes before? *

YES

NO

If YES, when did you attend, through what trainer/facility, and did you find the training beneficial?

What kind of excercise and activities does your dog do and how often?

Do you do any supplemental enrichment with your dog (puzzles, agility, etc.)? *

YES

NO

If YES, please describe:

Are there any other pets in the home? If so, please list species & ages:

Please list all members of the household, names, relationship and ages:

Any additional comments or information that you think we should know:

How did you hear about us?

I understand that I will be asked to sign a Services Agreement and submit my dog’s vaccination and health records before beginning services with UpSwing.

Your Signature

Select a date

Form Received -
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