Behavior Background
This form may take a few minutes. Please answer the following questions to the best of your ability. After filling out the form there is a basic liability waiver to be signed.
Human Name*
Pronouns*
She/her
He/him
They/them
Other
Full Address*
Phone Number*
Email Address*
preferred method of contact*
Email
Phone
Either
Please list any other people in the home along with their ages
Dog Name*
Sex*
Intact Male
Neutered Male
Intact Female
Spayed Female
Breed or best guess*
Dog's Age*
How did you acquire your dog?*
Do you have any other animals in the home? If so, please list along with species and age
Who is your regular veterinarian?*
May we discuss your dogs behavior with your veterinarian?*
Yes
No
Does your dog have any significant medical history or current medical conditions?
Does your dog have any allergies?
Does your dog take any medications?
Has your dog ever shown reactivity or aggression towards other dogs or animals?*
Yes
No
Unsure/It's complicated
If Yes please describe
Has your dog ever bitten or otherwise injured another dog or other animal?*
Yes
No
Has your dog ever shown fear, aggression, or reactivity towards people?*
Yes
No
Unsure/It's complicated
If so please describe
Has your dog ever bitten a person or otherwise cause harm?*
Yes, Broke skin
Yes, Did not break skin
No
Other
If Yes or Other please describe the situation, location, and severity of bite
What does your dogs average daily or weekly exercise routine look like?*
What are your goals for training?*
Has your dog had any previous training? *
Yes, owner trained
Yes, professional training
No
What training tools are you currently using or have used in the past?*
Prong collar
E Collar
Treats
Toys
Clicker
Harness
Gentle leader or other head halter
verbal correction
verbal praise
Physical correction
Crate
Pens, gates or other physical barriers
Muzzle
What previous training techniques or tools have worked or not worked?*
Is there anything else you would like me to know?