Twisted Clovers LLC
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Skills Request Form - Dog Board & Train
*
Indicates required field
Dog Name
*
Owner Name
*
First
Last
Obedience:
Check all that Apply
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Sit
Down
Here
Leave It
Touch
Recall
Stay
Kennel on Command
Heel with Loose Leash
Place Bed
Shake
High Five
Climb
NONE
General Service Dog Tasks:
Check all the Apply
*
Retrieve Dropped Items
Retrieve Named Items (phone, keys, leash)
Opening Doors
Closing Doors
Holding Doors Open
Opening Cabinets
Closing Cabinets
Opening Drawers
Closing Drawers
Opening Fridge
Closing Fridge
Remove Clothing with Tug (outerwear, socks)
Turning Lights On
Turning Lights Off
Deposit Garbage Into Can
Carry Mail From Mailbox to Home
Drop Recycling Into Bin
Put Items onto Countertop
NONE
Psychiatric Service Dog Tasks:
Check all the Apply
*
Medication Reminders
Deep Pressure Therapy (DPT)
Tactile Grounding
Interrupt Repetitive Self Harm
Retrieve Self Care Kit
Wake Up Handler Having Nightmares
Interrupt Flashbacks
Search House
Under legs for Blood Pressure
Body Block
Body Orbit
NONE
Medical & Alert Service Dog Tasks:
Check all the Apply
*
Laying on Chest
Nuzzling/Licking for Interruption
Alert Stimming
Retrieve Medication from Designated Spot
Bring Phone to Handler
Pulling Wheelchair
Momentum Assistance
Bring Cane to Handler
Carry Items in a Bucket
NONE
Mobility Support Service Dog Tasks:
Check all that Apply
*
Counterbalance
Nudges Hand or Foot back onto chair rest
Push Button to Open Doors
NONE
Comments or Other Commands:
*
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