Temperament Test Application Please enable JavaScript in your browser to complete this form.Temperament Test ApplicationName *FirstLastPhone *Email * Pet (dog) name: *Dog breed and age: *How long have you owned your dog? *What knowledge of your dog's history should we know? * We will use treats to encourage positive reinforcement. Does your pet have any dietary restrictions we need to know about? *Does your dog prefer human females or males? *MaleFemaleNo PreferenceAre there particular types of people your dog seems to fear or dislike? *Does your dog get along with other dogs? *YesNoHas your dog ever bitten another dog or person? If so, explain *Are there any dog types/breeds that your dog seems to fear or dislike? *Which of the following best describes your dog's level of socialization with other dogs: *None – No knowledge of other dog interactionMinimal – On leash encounters onlyModerate – Some off-leash playtime on occasion with visitor’s/neighbor’s/friend’s dog(s)Extensive – Regular visits to dog social events, off-leash dog parks, dog daycare, etc.What kind of games does your dog play with other dogs? *What kinds of games does your dog play with people? *What kind of vocabulary does your dog know? *What type of hand signals does your dog know? * What kind of toys does your dog prefer? * Do any visitors bring their dog (s) to your house? If yes, how do they get along? * Has your dog ever shared his/her food or toys with other animals? If yes, how does your dog react to another dog approaching his/her food or toys? *Does your dog growl, bark or snap when anyone passes outside of your home or yard? If yes, explain: *Does your dog growl, bark or snap when food or toys are taken away? If yes, explain: *Does your dog growl, bark or snap for any other reason? If yes, explain: *How does your dog react to a stranger coming into your home or yard? *Has your dog ever gotten away from someone when out for a walk? If yes, explain: *Has your dog had any other interactions in a boarding, daycare or dog park environment? If yes, explain: *How does your dog behave in public? *Has your dog had any problems previously in an off-leash social environment? If yes, explain: *What commands does your dog know? Does your dog know any tricks? *Has your dog had any problems previously in an off-leash social environment? Check all that apply *Altercation or fight at a public dog parkAltercation or fight with a neighbor or friend’s dogFearful reaction in a group of dogsNoneOtherPlease describe any behavioral problems you may know of: *Has your dog ever climbed or jumped a fence? *YesNoDoes your dog have current/history of physical disabilities or medical conditions we should be aware of prior to play time?Does your dog have any sensitive areas on his/her body? If yes, where? *Check the box below that best represents your dog's overall level of exercise routine: *Couch Potato: spends days sleeping, occasional walks and/or playtime with humans or dogsMild Exerciser: short daily walks and /or regular playtime with human or dogsModerate Exerciser: long or multiple walks daily and/or regular playtime with human or dogsAthlete: regular jogs/runs and/or regular participation in dog sport activity such as agility, flyball, frisbee, etc.Is there anything else to be aware of: *Thank you for the time you spent completing the application form. Please contact us if you have any questions on the next steps of the temperament test process. **After completion, please sign that you have read and understand the Owner Consent. Owner Agreement and ConsentPetsburgh Pet Care, its owner, employee(s), representative(s), or any other person(s) affiliated with Petsburgh Pet care will hereinafter be referred to as “Petsburgh Pet Care.” The undersigned dog owner, will hereinafter be referred to as “Owner.” I understand, and hereby agree that: Wellness Assurance: Petsburgh Pet Care, in order to admit my dog to participate in such social activities, has relied on my representation that my dog is in good health and has not been ill with any communicable disease in the last 30 days. I agree to inform Petsburgh Pet Care of any such communicable disease that my pet contracts in the future. Behavioral Representation: By submitting this Temperament Test Application, I am requesting that the staff of Petsburgh Pet Care evaluate and determine, in its sole judgement, whether my pet may be suitable for participating in the Social Group TLC program and/or other social programs hosted by Petsburgh Pet Care. Further, I represent that my dog has not harmed or shown aggressive or threatening behavior towards any person or any other dog, and I certify that I have offered all pertinent information relating to my dog’s behavior. Medical Needs: I am solely responsible for any harm that may come to my dog while it is attending Social Group Play Time. In my absence a problem or injury may develop or occur with my dog, and I understand that my pet will be treated immediately and without notification as deemed best by Petsburgh Pet Care, in their sole discretion. I understand that I will be notified as soon as possible and will have a full medical dismissal with veterinary staff at pick up. Liability: Although Petsburgh Pet Care screens the dogs for temperament, watches the dogs carefully and does not take aggressive dogs, Social Group Play Time can be hazardous, and dogs may be rambunctious. I agree to release Petsburgh Pet Care, other owners or any other parties from liability for any injuries, illness, damage and /or death to my dog while it is under the care of Petsburgh Pet Care. I will not hold Petsburgh Pet Care, other owners or any other parties liable for consequential damages under any circumstance. I assume full financial responsibility for any and all expenses involved. Incidents: My dog may be excused from Social Group Play Time at any time for good cause, as deemed appropriate by the Petsburgh Pet Care staff. I will be informed each time there is an incident with my pet. Two incidents, which results in removal from the group, will require reassessment to be considered “Cleared with Restrictions.” Two incidents despite restriction will lead to discontinuation of Social Group Play Time for my dog’s own safety as well as the safety of other pets and staff. Cameras: I understand that Petsburgh Pet Care utilizes cameras for security, promotional purposes and distance viewing. I understand that my pet’s picture may appear in Petsburgh Pet Care material and I give Petsburgh Pet Care permission to use and disseminate images or video without my express consent. Animal Acknowledgement: I understand that every dog reacts differently and that animals by nature are unpredictable. I understand that animals may bite or cause of injury to humans or other dogs without warning or apparent reason. I acknowledge and understand that there are certain risks that are involved in a social environment including but not limited to dog fights, dog bites, and the transmission of disease.I hereby certify that I have read and understood this agreement. I agree to abide by, and accept, all terms, conditions and statements in this agreement. Please select agree or disagree to the above paragraphs: *I agreeI do not agreeName *FirstLastDate *Submit