Name
*
First Name
Last Name
Preferred Pronouns
Email
*
Phone
(###)
###
####
How did you hear about us?
Dog's Name
*
Breed
*
Sex
*
Male
Female
Dog's Date of Birth
*
Is your dog spayed or neutered?
*
Yes
No
Not yet, but I will be getting the procedure done
When did you acquire your dog?
*
Where did you acquire your dog from?
*
What do you know about your dog's history?
*
Have you owned a dog before?
*
Yes
This is my first dog
As a child
Why did you choose this particular dog?
*
What kind of home do you live in?
*
Apartment
Townhome
House
Does your home have a fenced yard?
*
Yes
No
Do you and your dog live with other people?
*
Yes
No
Not yet, but I will be moving in with others
Yes, but I will be living on my own with my dog in the future
Are there children in the home or children your dog frequently sees?
*
Yes
No
Not yet, but there will be children around my dog in the future
Are there other pets in the home?
*
Yes
No
Not yet, but I am thinking about getting another pet
Does your dog have any known medical issues?
*
Yes
No
Unknown
Does your dog have any allergies?
*
Yes
No
Unknown
On average, how often is your dog left home alone?
*
On average, how much daily exercise does your dog receive?
*
Has your dog had any previous training?
*
Yes
No
Unknown
Is your dog housebroken?
*
Yes
Somewhat (frequent accidents)
Mostly (infrequent accidents)
No
Is your dog crate trained?
*
Yes
Somewhat - it is a work in progress
Not yet but I would like my dog to be
No
Does your dog get along with other people / strangers?
*
Yes, they love everyone!
Yes, they love familiar people but are wary of strangers
My dog seems neutral about interacting with other people
No, they do not like being around other people or strangers
Unsure
Describe how your dog behaves when interacting with other people or strangers
*
Does your dog get along with unfamiliar dogs?
*
Yes, my dog loves all dogs!
My dog has favorite playmates but is wary of unfamiliar dogs
My dog seems neutral about interacting with other dogs
No, my dog does not like being around other dogs
Unsure
Describe how your dog behaves when interacting with familiar and unfamiliar dogs
*
Does your dog struggle with any of the following?
*
Jumping
Barking
Humping
Nipping
Counter-surfing
Chewing inappropriate items
Other
None
What have you done to address the issue?
*
Has your dog ever bitten a person?
*
Yes
No
Unknown
Has your dog ever bitten another dog?
*
Yes
No
Unknown
Do you feel your dog has fears surrounding certain objects, people, or activities?
*
For example, a fear of thunder, the car, or nail clippers
Yes
No
Unsure
Do you feel your dog has separation anxiety?
*
Yes
No
Unsure
Describe what occurs when you or others leave
*
Do you feel your dog is reactive to people or dogs?
*
Yes to both
Yes to people
Yes to dogs
No
Unsure
Describe wha occurs when your dog meets a new person or dog
*
Do you feel your dog has a resource guarding problem?
*
Yes
No
Unsure
Are there any current problems with your dog that, if not addressed or managed, will cause the dog to be surrendered from your care?
*
Yes
No
Unsure
What is your dog's favorite activity?
*
What is your dog's least favorite activity?
*
What do you hope to achieve with training?
*
Is there a specific service you are interested in?
*
Basic Obedience
Loose Leash Walking
Behavior Modification
Virtual Privates
Consultation
Unsure
Is there any additional information you would like to add?
What are the most convenient days and times to schedule training?
*
Dates and times are not guaranteed and will be agreed upon by you and your trainer