Behaviour Questionnaire Please enable JavaScript in your browser to complete this form. – Step 1 of 2How did you hear of FLOPPS?Your Name *FirstLastDog(s) NameEmail *Phone Number *AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryWould you Like to receive emails for free training tips and upcoming events? *YesNoVeterinarians Office Name *Veterinarians Phone Number *Emergency Contact Name *FirstLastSomeone other than yourselfEmergency Contact Number *Is this your first dog?YesNoAge (state year or months old) *How old was your dog when you got him/her?Is your dog up to date on vaccinations? *YesNoREQUIRED VACCINATIONS By checking the boxes below, the owner of said dog, states that their dog has or will have up to date vaccinations required to attend training outside the home. The owners also understands that they must provide a copy of their dogs vaccinations records to the trainer prior to training *DHPP (Distemper, Adenovirus, Parainfluenza, and Parvovirus) Rabies Bordetella *All dogs must have the required vaccinations All vaccination records must be seen prior to training outside of the home. FLOPPS reserves the right to refuse access to any dog that does not have the required vaccinations required to train.Does your dog have any food allergies?Breed *SexFemaleMaleSelect One *SpayedNeuteredIntact Male – not fixed, not neuteredIntact Female – not fixed, not spayedHas this dog taken a class with FLOPPS before?YesNoIf so, when and what type of class?Has this dog taken any other dog training classes?YesNoIf so, when, and what type of class?Where did you get your dog from?BreederRescueHumane SocietyNewspaper / On-Line AdFamily/FriendOtherName of Breeder or RescueHas your dog lived with another family previously? If yes, please explain. *Has your dog(s) ever been assessed by your veterinary office for pain, allergies or behavioural or health problems? *Does your dog have any medical conditions? If so, please explain, including any medications or supplements that your dog is on. *Is your dog allowed inside? If no, why is this? If yes, how often? *How often do you feed your dog?Once a day Twice a day Three times a day My dog has food down in it’s bowl all day long What do you feed your dog?Canned food Dry food Table scraps Raw diet What brand of dog food do you feed your dog?Which best describes your dog's eating habits?Fussy Normal appetite Fast / Speed Eater If your dog doesn't eat all food at once, how long is the food left down?Does your dog have any potty accident problems in the house? Where does your dog sleep?On the bed Outside kennel On own bed, inside On own bed, outside In a crate Other Do you use a crate?YesNoHow much, on average, daily exercise does your dog get?Please describe your social layout of the family (people and pets) and your dogs daily routine with them.Has your household changed since acquiring the dog? If so, please explain.How your dog gets along with other animals in the household?Does your dog like children? If not, explain.How does your dog react to guests and strangers?How does your dog react to unknown dogs?Describe your dog's reaction to being left aloneWhere do you leave your dog when you go out?Describe your dog's reaction when you return homeDoes your dog pull on the lead when being walked?YesNoSometimesWhat equipment do you use to walk your dog? ie flat collar, check chain, harness, flexi lead etc.Have you seen any behaviours from your dog that we should be aware of? *What do you hope to accomplish in your training? *Please list all other undesired behaviours in order of highest priority to lowest.Has the behaviour stayed the same, gotten better or worse?How is your dog's behavior affecting your everyday life? *What are you afraid will happen if nothing changes? *What have you tried so far to fix the problem?Please list any commands that your dog knows reliably:Describe any and all instances of aggression including any biting, nipping or mouthing *Any additional comments or information you think I should know?NextWaiver & Terms of AgreementName of Participant in class, consultation or private training *FirstLastParticipants Day of Birth *Dog(s) Name *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryI understand that dogs can be unpredictable, and there is an inherent and unavoidable risk of injury to involved when interacting with any dogs, especially aggressive dogs. I further understand that dogs can be inherently difficult to control and that not all dogs will always be under control resulting in the possibility of injury to myself, my dog(s), other people and property. I understand that I am solely responsible for harm caused by my dog(s) at the time of the service and in the future and assume responsibility for all harm caused by my dog(s) to people, property and other dog(s). *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEI understand it is my responsibility to inform For The Love Of Paws Pet Service of all known behavioral and health concerns of my dog(s) and provide proof of vaccination prior to participating in Dog Training Programs. I further understand For The Love Of Paws Pet Service makes no representations, guarantees, promises, implied or expressed as to the temperament or aggressive tendencies, or vaccination status of other dogs in attendance at Dog Training Programs. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVETHE OWNER UNDERSTANDS AND AGREES THAT -THEY ARE BEING TRAINED TO TRAIN THEIR DOG(S) AND THAT WITHOUT 100% COOPERATION WITH THE TRAINER, FOLLOWING EACH STEP LAYED OUT BY THE TRAINER, THE DOG(S) WILL NOT GET TRAINED. -GETTING AND MAINTAINING THE TRAINING RESULTS DESCRIBED IN ANY TRAINING PROGRAM WILL VARY DEPENDING ON; HOW WELL THEY FOLLOW THE INSTRUCTIONS OF OUR TRAINER, HOW MUCH TIME THEY SPEND TRAINING THEIR DOG AND HOW OFTEN THEY PRACTICE THEIR TRAINING EXERCISES. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEI understand For The Love Of Paws Pet Service makes no representations, guarantees, promises, implied or expressed, that any training received by For The Love Of Paws Pet Service will lead to a desired training result or cure any dog(s) of any dangerous propensities. It is fully understood that regardless of the training received by the animal, any dog is always capable of biting. *I AGREEI understand that while using online training, I must exercise my discretion as the standard instructions may not be suitable for my circumstances. I further understand the Dog Training Programs are intended to assist in my dog training and are not intended as an exhaustive guide to address all situations which may arise. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEI understand For The Love Of Paws Pet Service makes no representations, guarantees, promises, implied or expressed, as to the ability of the Dog Training Programs to teach me how to safely train dogs. I agree that I am solely responsible for any harm caused by dog(s) while they are in my care and agree that For The Love of Paws Pet Service is in no way responsible for harm caused by dog(s) in my care. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEI understand that I may not participate in any in- person Dog Training Programs if I have experienced symptoms of Covid 19 within the past 14 days. I acknowledge Covid 19 transmission is difficult to prevent and there is a risk of Covid-19 transmission whenever I am in public with other individuals. I agree to voluntarily assume the risk that I may be exposed and or infected with Covid-19 by attending Dog Training Programs in person. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEI understand that by agreeing to this waiver of liability I relinquish my right to bring court action to be compensated for any loss to myself as well as the right of my personal representative to compensation for the death of the person that signs this agreement. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEI willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any harm, financial or physical including injury or death that may result from participation in any Dog Training Program at For The Love Of Paws Pet Service. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEHEALTH -I, the above listed Dog Owner and the legal owner / care provider of the pet(s) noted in this agreement, I, do hereby state the following information is true and complete to the best of my knowledge. I understand For the Love of Paws Pet Service may utilize some or all of this information during the dog(s) training program and I have taken special care to present the information in an accurate fashion. -I ensure my dog(s) are in good health and will not attend lessons if my dog(s) are ill or injured. -I ensure the good health of myself, any attendees and participating dog(s) prior to and during any classes and will not attend if there is any possibility that my dog or I may be ill or injured. *I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES LISTED ABOVEDISCLAIMER: FOR THE LOVE OF PAWS PET SERVICE AND ALL ITS AFFILIATES, OFFICERS, DIRECTORS, SHAREHOLDERS, EMPLOYEES, COACHES, INSTRUCTORS, VOLUNTEERS, PRINCIPALS, AGENTS, INDEPENDENT CONTRACTORS, CONTRACTORS, SERVANTS, REPRESENTATIVES AND THE LANDLORD/OWNER OF THE BUILDING ( “FOR THE LOVE OF PAWS PET SERVICE”) ARE NOT RESPONSIBLE FOR ANY DEATH, LOSS OR DAMAGE OF ANY KIND, SUFFERED BY ANY PERSON WHILE UTILIZING OR PARTICIPATING IN THE DOG TRAINING PROGRAMS* CAUSED IN ANY MANNER WHATSOEVER, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF FOR THE LOVE OF PAWS PET SERVICE. *In this agreement “Dog Training Program(s)” shall include all activities, programs, events, classes and services provided, sponsored or organized by For The Love Of Paws Pet Service , including, but not limited to: dog training workshops , dog training lessons/classes, business plans, written material and homework, marketing and business advice, and all other such related activities whether or not the aforementioned services and or materials are provided digitally, online, or in person. *I AgreeAGGRESSIVE BEHAVIOR By choosing YES in the box below , I, – acknowledge that if F.L.O.P.P.S. determines that my dog(s) is aggressive and understand the outcome of any training/counselling program cannot be guaranteed and the aggressive behaviour on the part of my dog(s) is or may become a risk to people and/or dogs, my decision to enrol in a training program is done solely and completely at my discretion with me taking 100% responsibility for any damage my dog(s) might cause to anybody during or after the training program. -agree that F.L.O.P.P.S does not promise to solve or curtail my dog’s aggressive behaviour. -agree to take all possible safety measures recommended by my trainer, including but not limited to muzzling and leashing my dog(s) when around dogs and/or other people. *YesDESCRIPTION OF RISKS: In consideration of For The Love Of Paws Pet Service allowing me to enroll in their Dog Training Program(s), I hereby acknowledge that I am aware of the risks associated with the participation in Dog Training Program(s), (INCLUDING THE RISK OF SEVERE OR FATAL INJURY TO MYSELF OR OTHERS). These risks include, but are not limited to: -All injuries to myself and/or other(s) including but not limited to: puncture wounds, bruises, scrapes, cuts, sprains, dislocations, broken bones, and head, facial or dental injuries which might result from my dog(s) or other dog(s) attacking myself another person, or property; or the attempts of For The Love Of Paws Pet Service, another person or myself, to control dog(s) enrolled in the Dog Training Programs. -Injury or death due to improper use or failure of equipment including but not limited to muzzles, harnesses, collars and leashes; -Legal expenses including but not limited to damages in a personal injury arising out of harm caused by my dog(s) to other person(s) ; -Exposure and or infection with Covid-19 which may result in personal injury, illness, permanent disability and death of myself or other(s); -Injury or death due to negligence on the part of myself, For The Love Of Paws Pet Service, or other people around me. *I AgreeGOVERNING LAW I AGREE THAT THE LAWS OF THE PROVINCE OF ALBERTA SHALL GOVERN THE VALIDITY OF THIS WAIVER INCLUDING IT’S INTERPRETATION AND ANY DISPUTE OR CLAIM I HAVE AGAINST FOR THE LOVE OF PAWS PET SERVICE. I AGREE THAT ANY CLAIM OR DISPUTE I HAVE AGAINST FOR THE LOVE OF PAWS PET SERVICE MUST BE RESOLVED BY A COURT LOCATED IN THE PROVINCE OF ALBERTA. I FURTHER IRREVOCABLY AND UNCONDITIONALLY SUBMIT TO THE EXCLUSIVE JURISDICTION OF THE COURTS IN THE PROVINCE OF ALBERTA FOR THE PURPOSE OF LITIGATING SUCH CLAIMS OR DISPUTES. *I AgreeCanadian Residency I represent and warrant that at the time of my participation in any Dog Training Programs offered by For The Love Of Paws Pet Service, including online services, that I am a resident of Canada, and that myself and my dog(s) are located in the country of Canada. I acknowledge and understand that I may only participate in Dog Training Programs if I am a resident of Canada, over the applicable age of majority and only while myself and by dog(s) are located in Canada. *I AgreeTERMS & CONDITIONS In person Classes I understand that any in person classes or private sessions may be switch to live online classes or sessions at anytime and is at For The Love Of Paws Pet Service discretion to do so. I agree to participate in live online classes or private sessions if they are changed to from in person classes or private sessions. *I AgreeCanadian Residency I represent and warrant that at the time of my participation in any Dog Training Programs offered by For The Love Of Paws Pet Service, including online services, that I am a resident of Canada, and that myself and my dog(s) are located in the country of Canada. I acknowledge and understand that I may only participate in Dog Training Programs if I am a resident of Canada, over the applicable age of majority and only while myself and by dog(s) are located in Canada. *I AgreePhoto and Video I grant to For The Love Of Paws Pet Service permission to use, reproduce, distribute and publish to use my name, my dogs name and any photograph(s), video and audio recording(s), sound recording(s) or other electronic representation(s) taken during the Dog Training Programs provided by the For The Love of Paws or provided by me to the For The Love of Paws Pet Service (“Digital Material”). I release For The Love of Paws Pet Service from any and all liability resulting from use reproduction, distribution and publication of the Digital Material. I further authorize the reproduction, sale, distribution, copyright, broadcast and/or electronic storage of the Digital Material and I waive any right to any compensation I may be entitled to in relation to the Digital Material. *I AgreeI DisagreeSafety Checks: Some training services may be held in outside in unfenced area and it is my sole reposibililty to check my dogs eqiptment to make sure it is attached securely to my dog. I am responsible for maintaining control over my dog and for holding its leash securely at all times. *I AgreeACKNOWLEDGMENT: I acknowledge that I am at least 18 years old, and have the right and ability to consent to the terms herein. I further acknowledge that I have read, understood and agree to the terms of this agreement, that I have executed this agreement voluntarily, this agreement is to be binding upon me, my heirs, executors, successors, administers, assigns, transferees and representatives. *I AgreeACKNOWLEDGEMENT: By signing below I am agreeing to FLOPPS Terms of Service and Privacy Policy @ http://flopps.ca/terms-of-service-and-privacy-policy/ *I AgreeSignature of Participant As participant, the legal owner/agent / care provider of the pet(s) named above, do hereby agree to all of the above information. *typing your name in this area legally represents your electronic signature *FirstLastSignature of Witness *typing your name in this area legally represents your electronic signature *FirstLastSigned this day *WebsiteSubmit