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PRIVATE IN-TAKE FORM

Welcome to the PackLeader Academy Private Training Program

Take the first step toward a calm, confident, and well-behaved companion.

Every dog is unique, and group classes aren't always the right fit for every behavior goal. Whether you are struggling with stressful leash reactivity, severe separation anxiety, house manners, or you simply want a customized training plan tailored to your busy lifestyle—our Private Training Program is designed to deliver fast, real-world results.

At PackLeader Academy, we don’t just train your dog; we give you the tools, confidence, and leadership skills to handle any situation. Let’s cut through the frustration and get your dog's behavior back on track.

Please fill out our comprehensive private intake form below so Mimi can deeply analyze your dog's current behavior and map out the perfect strategy for your first session.

Private in-take form

& Board & Train Clients

Owner Basics

*If your dog is aggressive with humans and dogs and has bitten someone and tasted blood, your dog is red-lined, and I am not equipped and don't have the skill to handle that level of Behaviour Modification. You will need a Certified Applied Animal Behaviorists (CAAB) or a Board-Certified Veterinary Behaviorists (DACVB)

*First name

*Last name

*Email

*Phone

Multi-line address

*Country/Region

*Address

*City

*Zip / Postal code

*How did you hear about our Behavioural Modification programs?

Google Maps

Google Business page

Social Media

Browser search

Friends or Family

Flyer

Yelp.ca

Blog

*When would you be available for a lesson?

Evenings, Weekends etc...

Pup Basics

*Dogs Name

*Dog's age

*Dogs Breed/Mix

*Dogs Sex

Male

Female

Health & Vaccination Records

*Is your dog altered?

Spayed/Neutered

Intact

Puppy

*Are your dog's vaccinations up to date?

Yes

Titer

*Submit copy of vaccine records

Behavioral Profile & History

Is your dog/puppy a rescue?

Please mention if this is an international rescue

What information do you have if this was a rescue?

*How old was your dog when you got him/her?

*Where did you get your dog?

(e.i. rescue, local shelter, adopted, breeder or other.)

*If you were able to pick from the litter, do you know if the pup was the runt, middle or in front (alpha/top dog)?

List any pertinent Medical issues

Any physical limitations, recent surgeries/illness etc.

What is your dog's diet?

*Does you dog have any Allergies?

*Please describe any behavioural issues you might be dealing with:

*When did these issues show up and how long have they been happening?

*What is the trigger i.e. the situation that causes the reaction

*What have you tried already, but is not working for you or your dog?

Dog trainers, online advice, books, etc...

*How much Socialization with dogs and other humans did your dog get in the first 6 months of their life?

*How does your dog respond to new dogs out in public?

Excitable

Friendly

Calm

Timid/Anxious

Fearful/Aggressive

Unruly and Lunging

Choose all that apply

*How social is the dog, daily or weekly, and what kind of social situation is it?

Off Leash dog parks, On leash interactions with all sizes and breeds, family dogs, family members, children etc.

*How does your dog react to strangers?

Friendly

Excitable

Calm

Timid/Shy

Fearful/Aggressive

Barking/Lunging

In what situation does your dog show excitement? Describe your dog's reaction.

*Is your dog Aggressive/Fearful?

*Does your dog show stress under certain situations?

Cowering, licking lips, shake, piddle accidents etc...

*Does your dog show aggression towards certain types of people?

Men, men in hats, different culture, in uniform etc...

*Has your dog ever bitten anyone?

YES

Human, dog or any other pet, animal like horse, farm animal etc...

If yes, please describe the situation in detail.

Not puppy nipping but drawn blood, so a puncture or tear of the skin where the dog tasted blood.

Is your dog resource guarding?

Guards food bowl, a human in the pack, a toy etc...

*What is your dogs daily exercise routine?

What tools and equipment do you use when exercising your dog?

Martingale, flat soft collar, prong collar, Harness, retractable or 6' leash?

What level of skills do you and your dog have?

Basic

Intermediate

Advanced

Commands your dog responds to right away and remains in command?

Sit

Stay

Down

Stand

Come

Heel

Wait

Leave it

Hand Signals

Choose all that apply

*What are your priorities for getting help with your dog?

You want to be involved and learn new leadership skills or you want the dog to get trained.

Would you like a verbal follow-up or a detailed list of our initial assessment?

A phone call or a written list of issues we need to work on.

Is there anything you would like me to know about your dog?

Learning style, physical limitations etc.

Comments and Questions:

Agreement & Verification

*Today's Date

*Have you submitted a signed Waiver yet?

YES

If no, click this link to go to the form; Service Agreement & Liability Waiver

*Signature

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*We respect your privacy. We do not sell or share your personal information with third parties for marketing purposes.

The PupHaus, home of Doggy DooLil Daycare & PackLeader Academy is a premium, home-based pet care and training provider proudly serving Surrey (Whalley), Delta, Langley, Coquitlam, Richmond, Fraser Heights, Guildford, Clayton, Newton, Fleetwood, White Rock, and New Westminster, BC.
To maintain a safe and calm environment for our pack, our private home location is shared exclusively with clients upon booking. Contact us today to schedule your dog's evaluation.