INTRODUCING

Reactivity Program

Beyond The Bark

Thank you for taking the time to complete our form. Please provide accurate information about you and your dog so we can tailor our services to your needs. Fields marked with an asterisk (*) are required. Your responses help us ensure a safe, effective and personalised experience.

Your Information

First Name *

Last Name *

Phone *

Email *

Date of birth

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Address

Street Address *

City

Suburb *

Postal code

Emergency Contact Name

Emergency Contact Phone Number

How Did You Hear About Us?

Facebook

Instagram

Tiktok

Other

Referred

Other

Referred Friend First Name

Feferred Friend Last Name

Canine Information

The information you provide about your dog is essential to creating a personalised training plan. Understanding their behaviour, personality and history allows us to tailor our approach for the best results.

Please complete all sections accurately, as these details ensure a safe and productive experience. Your input is vital to helping your dog succeed.

Thank you for your cooperation. We’re excited to work with you and your canine

Dog name *

Dogs Age

Sex *

Male

Female

Breed

Is Your Dog Neutered *

Yes

No

Booked in

Age When Desexed

Has Your Dog Ever Been Prosecuted Or Classified By Local Council *

Yes

No

Is your dog vaccinated? (We require all dogs to be fully vaccinated with current and up to date shots, and we may require a copy of your dogs Verterinary book/s to confirm). *

Yes

No

Booked in

Is Your Dog On Any Medication

Yes

No

Medication(If Yes Please State)

Known Medical Conditions/ Allergies

At what distance does your dog notice or react to their trigger

1 m

5 m

10 m

My dog will react to:

Dogs

People

Cars

Cyclist

What have you tried so far to manage your dog’s reactivity?

Anything Else We Should Know

I have read and agree to the terms and service & refund policy

I give 100%K9 permission to record and use images, video and audio of me and my dog for training, marketing and education. This right is worldwide, permanent and royalty free, and all media will belong to 100%K9

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