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Name *

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Last

Address *

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City

State

Zip Code

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Cell Phone Number *

Home Phone Number *

Work Phone Number *

Email *

Dog's Name *

Dog's age and date of birth *

Breed of dog *

Sex *

Colors *

How did you adopt your dog (breeder, shelter, etc.?) *

Date you adopted your dog. *

Reasons you selected this dog. *

Vet name, address and phone number. *

Any health issues? Allergies, etc? Please explain. *

Medications your dog is currently taking. *

Date Spay/Neutered. *

What behavorial or training issues are you seeking help with? *

When did the issues begin? *

What do you think is causing the problems or issues? *

What methods have you tried to connect or train the issues? *

What results have you had with your methods? *

What training education has this dog had? *

What commands/words does your dog know and respond to? *

How many persons are in your household? *

How many children under 2 live with this dog? *

How many children 2-4 years old live with this dog? *

How many children 5-12 years old live with this dog? *

How many teenagers live with this dog? *

Please list any other pets in the household. *

How does your dog interact with the other pets? AND Who would you say is in charge among the pets? *

What brand of food do you feed? How much and how often to this dog? *

Who feeds the dog? *

Does your dog eat all the meal at once, or doyo ufree feed? *

Do you have this dog sit before giving the meal? *

Do you give this dog get treats? *

Do you give this dog leftover people food? *

What are some of the house rules for this dog? *

Who trains the dog? *

How often do you work on dog training? *

How does the dog do with your training methods? *

What training methods have you tried? *

Who disiplines the dog? *

How does the person disipline the dog? *

Where does the dog sleep? *

What is the dogs exercise routine? *

How many hours of exercise does the dog get each day? *

What are the dogs favorite ways to play? *

How many hours per day does your dog spend alone? *

How does your dog respond to other dogs? *

How does your dog repsond to non-dog animals? *

How does your dog respond to children? *

How does your dog respond to strangers? *

How much time can you commit per day to work with your dog on training/behavorial issues? *

Have you had any recent changes to the household? *

What behaviors do you like most about this dog? *

What behaviors do you like least about this dog? *

What changes are you looking for with this dog? *

Please add anything we may have not covered that you deem to be important about your relationship with this dog. *

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