Private Lesson Questionnaire

Type of lesson

Fill this out before your first private lesson. The more you tell us, the more of the lesson we can spend on training and problem solving. Your answers are saved on this device as you go.

What is the lesson for?

About you

For example your instructor, veterinarian, a neighbor or a friend.

Your dog

Tell us about the dog this lesson is for.

The dog this lesson is for

Owner, breeder, rescue or shelter name.

Second dog

Owner, breeder, rescue or shelter name.

Third dog

Owner, breeder, rescue or shelter name.

Daily life

This gives the instructor a picture of your dog’s daily and weekly routine. Skip anything that doesn’t apply.

A typical workday

Wake-up, potty, activities, meals, your schedule, crated or loose, bedtime.

Behavior Issues

Rate any of these behaviors you’d like help with, from 1 (least important) through 3 (neutral) to 5 (most important). Leave anything that doesn’t apply. On the next page you’ll describe the ones you rated, including when they happen and what seems to set them off.

Behaviors

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Behavior Issues: tell us more

Please describe each of these in a few words.

Aggression

If your dog has shown aggression, rate how important each one is to work on, from 1 (least important) through 3 (neutral) to 5 (most important). Leave anything that doesn’t apply. On the next page you’ll describe what happened. Please include any bites or injuries, even minor ones: it helps us choose the right instructor.

Aggression

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Aggression: tell us more

Please describe each of these in a few words.

Household Issues

Rate any household issues you’d like help with, from 1 (least important) through 3 (neutral) to 5 (most important). Leave anything that doesn’t apply. On the next page you’ll describe the ones you rated. If you have more than one dog, say which dog.

Around the House

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When Visitors Come Over

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Household Issues: tell us more

Please describe each of these in a few words.

Basic Obedience Skills

Rate the skills you’d like to work on, from 1 (least important) through 3 (neutral) to 5 (most important). Leave anything that doesn’t apply. On the next page you’ll tell us more about the ones you rated.

Basic Obedience Skills

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Basic Obedience Skills: tell us more

Please describe each of these in a few words.

What you’d like to work on

This form is for performance class skills (competition obedience, agility, breed ring, therapy dog and so on). For housebreaking, crate training, basic home obedience, behavior problems, aggression or anxiety, please choose the other type of lesson.

Please be specific and list them in order of priority, so we have time for the most important things.

YouTube, Vimeo, Google Drive or similar. If you have a video camera, bring it to the lesson.

A few more questions

Based on your answers, our instructors would find these helpful. They’re optional.

Scheduling

Give us several options to choose from.

Agreement

At this time we only do in-facility private lessons; lessons away from the dog’s home are often more effective. (If an in-home or field-trip lesson would be a good next step, we’ll talk with you about it when we meet.) An obedience and behavior private lesson is $140 for the first hour in our facility, plus $25 for each extra 15 minutes. There’s no sales tax on private lessons. Payment is due at the time of the lesson. We accept cash, checks, Visa, MasterCard and Discover.

The average private lesson lasts about an hour. Our staff reviews your answers and does any research beforehand. You’ll get homework, and we’re available for follow-up by email or phone. After we review your questionnaire, we’ll contact you to arrange the lesson and tell you who you’ll be meeting with. If possible, the whole family should come to the lesson; if not, let us know and we may be able to video it (you’re welcome to bring your own camera). Please be ready to take notes.

A private lesson is like a doctor’s prescription: your instructor will give you specific instructions to reach your goals, but it’s up to you and your family to follow through with the training, behavior modification, exercise and lifestyle changes.

Private lesson agreement

I understand that private lessons must be canceled at a minimum of 24 hours in advance or I will be charged the full amount of the scheduled lesson. Returned or NSF checks are subject to a $30 bank processing fee. Declined credit cards are subject to a $30 late payment fee.

I agree to indemnify and hold harmless Kathy Lang Dog Training Services, Inc., The Family Dog Training Center, and its owners, board of directors, officers, agents, employees, instructors, and staff members, from any and all claims, demands, actions, causes of action or liability of any kind whatsoever, for death, personal injury or property damage in any way proximately caused by myself, my family members, my friends and/or any animal belonging to, or brought onto the premises by myself or any member of my family or my assigns. I further agree on behalf of myself, my family and my assigns, to assume complete and sole responsibility for any and all actions of any animal belonging to, or brought onto the premises by myself, any member of my family or my agents or assigns.

Agreement

At this time we only do in-facility private lessons; lessons away from the dog’s home are often more effective. (If an in-home or field-trip lesson would be a good next step, we’ll talk with you about it when we meet.) A performance and skills private lesson is $70 for the first hour in our facility, plus $25 for each extra 15 minutes. There’s no sales tax on private lessons. Payment is due at the time of the lesson. We accept cash, checks, Visa, MasterCard and Discover.

The average private lesson lasts about an hour. Our staff reviews your answers and does any research beforehand. You’ll get homework, and we’re available for follow-up by email or phone. After we review your questionnaire, we’ll contact you to arrange the lesson and tell you who you’ll be meeting with. If possible, the whole family should come to the lesson; if not, let us know and we may be able to video it (you’re welcome to bring your own camera). Please be ready to take notes.

A private lesson is like a doctor’s prescription: your instructor will give you specific instructions to reach your goals, but it’s up to you and your family to follow through with the training, behavior modification, exercise and lifestyle changes.

Private lesson agreement

I understand that private lessons must be canceled at a minimum of 24 hours in advance or I will be charged the full amount of the scheduled lesson. Returned or NSF checks are subject to a $30 bank processing fee. Declined credit cards are subject to a $30 late payment fee.

I agree to indemnify and hold harmless Kathy Lang Dog Training Services, Inc., The Family Dog Training Center, and its owners, board of directors, officers, agents, employees, instructors, and staff members, from any and all claims, demands, actions, causes of action or liability of any kind whatsoever, for death, personal injury or property damage in any way proximately caused by myself, my family members, my friends and/or any animal belonging to, or brought onto the premises by myself or any member of my family or my assigns. I further agree on behalf of myself, my family and my assigns, to assume complete and sole responsibility for any and all actions of any animal belonging to, or brought onto the premises by myself, any member of my family or my agents or assigns.