Behavior Consultation Form

Name *
Other Phone
Other Phone
May we share your training & behavior report with your veterinarian?
I will provide a copy of proof of Rabies Vaccination by email or at the first session. *
If no please explain. Depending on your dogs history we might not work with your dog until Proof of current vacination is produced.
My dog came to me
Check off which training methods you have tried with this dog
Please check any method you have tried, even if it was a while ago. We can discuss.
Do you use a dog door?
Write %: For example, 50% outside, 50% inside.
Do you take your dog to the dog park?
Please check off traits which apply to your dog
Snaps, Punch with muzzle, Bites, Nips, Torn clothes *
Thank you for your honesty. Things to include : did your dog cause a puncture or scratch? Where was the nip,rip or bite? Who/what was the victim? Were the police, animal control or insurance company involved?
Policies and Liability
Payment Policy *
Payment made by cash or check at registration or at beginning of session(arrangement made in advance). By checking the box below I have read, understand, agree to the above.
Cancellation and Refund Policy *
Refunds and cancellations are offered until 72 hours prior to the scheduled session start date. To offer individualized attention no refunds will be offered if cancellation is less than 72 hrs, or a no-show. By checking the box below I fully I have read, understand and agree to the above.
Photography and Video Release Authorization Form *
From time to time, photos and videos may be taken of students/event participants and their dogs during private and group dog training classes, practice sessions, demos, presentations and events organized by Sea Change Canine LLC. Sea Change Canine LLC reserves the right to use these photos and videos for educational and marketing purposes, its website, presentations, etc. By checking the box below, I hereby grant permission to Sea Change Canine LLC to use photos and videos of myself, my family and my guests as well as my dog(s) for the publications listed above.
Liability Waiver *
Sea Change Canine llc, Sarah Becker owner, will endeavor to create as safe an environment as possible for the training of my dog and will offer only sound, safe and responsible training and training instructions. However, I recognize that Sea Change Canine llc, Sarah Becker , owner, is not responsible for any unintentional errors, omissions, or incorrect assertions. I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service. Further, I am and will remain responsible for the actions of my dog at all times and I hereby agree to indemnify and hold harmless Sea Change Canine llc, Sarah Becker, owner, of any and all claims of injury, expense, costs, or damages caused by the actions of my dog while under Sea Change Canine llc, Sarah Becker owner, instruction or control and under my own care as a result of following training instructions. I have been told by Sea Change Canine llc, Sarah Becker owner, and understand the inherent risks of owning a dog,including but not limited to the risk of dog bites to myself or others. By checking the box below I fully I have read, understand and agree to the above.
Safety Measures *
I understand use of equipment such as shock collars ;prong collars and choke chains can exacerbate aggression. I agree to follow safety measures discussed in my training program, such as the use of a muzzle. By checking the box below I agree to follow recommended safety measures.
Owner Responsibility *
I the owner/handler am ultimately and always responsible for the dog’s safety and the public’s safety, and that as an owner/handler assume 100% responsibility for the dog and the dogs' actions at all times. I as owner/handler agree to compensate Sea Change Canine LLC, Sarah Becker owner, any damages and costs of a claim, as well as attorney’s fees in the event of a third (3rd) party lawsuit. I as owner/handler warrant that I have disclosed to Sea Change Canine LLC, Sarah Becker, owner, that the dog may be fearful/reactive or aggressive to other dogs or to people, including but not limited to growling, forceful barking, snapping, raising of hackles, lowering head and staring, chasing, attempting to bite or biting. I as owner /handler understand that while Sea Change Canine LLC, Sarah Becker, owner, may be able to address some forms of fear, reactivity, aggression, many fearful/reactive/aggressive dogs require long-term treatment following a specific plan of action. I owner/handler understand that it is my responsibility to follow thru with training my dog. I as owner/handler understand that after the initial session if I do not make written contact or follow up training after 60 days this contract is null and void. I owner/handler further understand that some forms of fear/reactivity/aggression cannot be addressed with behavior modification and may require medication or euthanasia, both of which are outside the scope of this contract. Sea Change Canine LLC, Sarah Becker owner, reserves the right to refuse or discontinue services for a fearful/reactive or aggressive dog, in which case Sea Change Canine LLC, Sarah Becker owner, will have no further obligation to owner/handler. By checking the box below I fully I have read, understand and agree to the above.