Standard Intake Form

After your 15 minute discovery call, please fill out this form as well as the Agreement and Release Form

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Agreement & Release Form

All individual clients must sign this waiver prior to working with The Canine Life Coach.

Please click below and fill out this form.

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Group Class Intake Form

All group class clients must sign this waiver prior to working with The Canine Life Coach.

Coming soon!

New Client Intake Form

NEW CLIENT INTAKE FORM

Client and Dog Information

This intake form helps me get to know you and your dog before our session. It’s very detailed, so if something doesn’t apply, feel free to skip it! The more info you provide, the better I can tailor our training to meet your needs and make the most of our time together.

Please note, if there is an asterisk (*), the field is required.

Let’s get started!

First and Last name

Mailing Address

Phone

Dog's name

Dog's breed(s)

Dog's approximate age

Dog's gender

Dog's weight

Has your dog been neutered/spayed?

Yes

Family Information

How many humans live in your home? How many are over 18 and how many under 18?

Do you have any other animals (species)?

History

How long have you had your dog?

From where did you get your dog? Describe what you know about their history:

How many previous homes did your dog live in?

Known medical or behavioral issues in those homes. If none, please answer "none".

Please share any other pertinent information about your dog and their history before coming to your home.

Training History

Please describe your training goals (what outcome would you like to see).

Have you already trained your dog to do any behaviors, and if so, what are they?

If yes, how did you train those behaviors?

On average, how much time are you able to spend working on training/behavior modification exercises throughout the day and/or week?

Environment and Routine

Where does your dog sleep?

How much sleep does he/she get per night?

How much sleep does he/she get during the day, and approximately what time(s) of day?

Do you have a secure, fenced-in yard?

Yes

How does your dog get exercise? Approximately how much exercise per day?

What kind of training and/or walking equipment do you use?

Please describe your pet's routine on an average day. If you have a different routine for different days, describe the different routines.

Please provide any additional information you think might be helpful.

Behavior

If your dog has nipped or bitten a person or other animal (teeth have touched skin in not a playful way), describe one or more incidents.

Please describe the behavior in terms of clear, observable body language. In other words, what specific behavior are you seeing with your eyes?

How long has this behavior been occurring?

Did it start suddenly, or has it gradually been getting worse?

When and where does it occur?

What happens just before the unwanted behavior occurs?

What happens right after the behavior occurs?

What have you tried in the past to change this behavior?

Has your dog already been seen by a vet or other type of professional for this behavior? If yes, please describe.

What made you decide to seek help now?

Nutrition

What kind of food(s) does your dog eat?

Any food allergies? If yes, please list.

How much food is offered each day?

How predictably does your dog eat? Please describe your dog's appetite.

What is the delivery method of the food (e.g. bowl, food puzzle(s), training sessions, etc.)?

Please list any known favorite foods or treats

Medical

Who is your vet?

Does your dog have any known medical conditions? If so, what are they? How are those conditions being treated/managed?

Describe any known allergies and treatment (if being treated):

Current medications and/or supplements:

If your pet has any concerning symptoms that have not yet been medically addressed, please list them.

Client Agreement and Release Form

The Canine Life Coach

Client Agreement and Release Form

Client First and Last Name

Please provide your first and last name.

Dog Name

Please provide your pet's name.

Phone

Address

TERMS & CONDITIONS

Client authorizes Mo Lynch Vashel of The Canine Life Coach to perform services as outlined in this agreement, including: Dog Training, Behavioral Consults, Other Service (As mutually approved)
Emergency Veterinary Care: Mo Lynch Vashel, of The Canine Life Coach, is authorized by Client signature below to seek emergency veterinary care with release from all liabilities related to transportation, treatment, and expense. Should specified veterinarian be unavailable, Trainer/Company Representative is authorized to approve medical and/or emergency treatment (excluding euthanasia) as recommended by a veterinarian. Client agrees to reimburse Trainer/Company Representative for expenses incurred. The company is released from liability and cost of the injuries
Vaccinations: All pets must be current on all vaccines, and a copy placed on file with Trainer / Company.
Liability for Injury: Mo Lynch Vashel owner of The Canine Life Coach or any person associated with the canine life coach is bitten or otherwise exposed to disease or ailment received from Client's animal(s), Client will be responsible for paying all costs and damages incurred by Trainer/Company Representative.
Client takes full responsibility for dog(s) behavior and any injury caused to another animal or person by that behavior and agrees to reimburse Trainer/Company Representative for any liabilities or cost arising from injuries caused by said dog(s).
Right of Termination: Mo Lynch Vashel owner of The Canine Life Coach reserves the right to terminate this contract at any time before or during its term if Trainer/Company Representative, in its sole discretion, determines that Client's pets pose a danger to the health or safety of Trainer/Company Representative, the public or other animals in its care or custody.
Approval for Services: Client authorizes this signed contract as valid approval for future services of any purpose provided by Company, including permitting Company to accept telephone reservations for service and enter premises without additional contracts or written authorization.
Cancellation Policy: At The Canine Life Coach, we value your time and ours. To ensure that every client has access to the support they need, we ask that all cancellations or rescheduling requests be made at least 24 hours in advance.
- Cancellations must be made by text, phone call or voicemail to (925) 389-1799. Social media messages and emails will not be accepted for cancellations.
- Cancellations made with less than 24 hours’ notice will be subject to a 50% cancellation fee.
- No-shows (appointments missed without any notice) will be charged the full cost of the session.
We understand that emergencies happen—please communicate with us as early as possible if something unexpected comes up. Thank you for helping us keep our schedule running smoothly and allowing space for other clients who need support.
Refund Policy: Once group classes or private lessons have commenced there will be no refunds given.

I have reviewed and understand this Service Agreement and agree to the terms as defined on this form. In addition, I consent to the use of photographs of me and my dog and agree to use on The Canine Life Coach marketing materials including social media.

I hereby consent to the recording of my dog's training sessions conducted by The Canine Life Coach, using artificial intelligence (AI) technology to assist in creating follow-up training reports and emails. I understand that these recordings, including video and audio materials, may be securely stored and utilized for the following purposes:

I understand that any use of the recordings for educational purposes will be done in a manner that protects my privacy and does not disclose my personal information unless expressly agreed upon in writing.

By signing below, I agree to release The Canine Life Coach from any liability associated with the use of the recordings for the above-stated purposes, and I confirm that I have the legal authority to grant this consent.

Confirm with your initials