Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Sex *

Male

Female

Spayed/Neutered? *

No

Yes

Has your dog had any previous training? *

No

Yes

Does your dog have any known fears or anxieties? *

(e.g., loud noises, strangers, separation anxiety…)

No

Yes

Has your dog ever shown aggression toward people or other animals? *

No

Yes

Has your dog ever bitten a person or another animal? *

No

Yes

Does your dog have any possession/aggression tendencies? *

(e.g., guarding or aggression with food, toys, space, people…)

No

Yes

How does your dog react to other dogs? *

Select all that apply.

Friendly

Shy

Fearful

Aggressive

Overexcited

Other

How does your dog react to strangers? *

Select all that apply.

Friendly

Shy

Fearful

Aggressive

Overexcited

Other

Does your dog show signs of... *

Select all that apply.

Possession / aggression (food, toys, etc.)

Separation anxiety

Excessive barking

Jumping on people

Fear of loud noises (thunder, fireworks, etc.)

Have you ever picked up your dog and noticed a negative reaction? *

Select all that apply.

No

Yes

Have you ever noticed your dog reacting negatively to being touched or to sudden movements? *

Select all that apply.

No

Yes

Does your dog have any issues with bathroom habits or marking behavior? *

Select all that apply.

No

Yes

Commands your dog knows *

Sit

Stay

Down

Come

Heel

Off

Leave it

Place

Out

Other

Does your dog respond to their name? *

No

Yes

Does your dog recall to their name? *

No

Yes

How is your dog motivated? *

Food

Toys

Affection

None of the above

Does your dog live with other pets? *

No

Yes

Where does your dog stay most of the time? *

Inside

Outside

Both

Where does your dog sleep at night? *

Crate

Dog Bed

Owner’s Bed

Outside

Other

How often does your dog get exercise? *

Daily

Few times a week

Rarely

Does your dog have experience with... *

Car rides

Grooming

Nail trimming

Vet visits

Any known health issues or injuries? *

No

Yes

Is your dog currently on any medications? *

No

Yes

Does your dog have any allergies we should be aware of? *

No

Yes

What are your primary training goals for your dog? *

Basic obedience

Behavioral issues (e.g., reactivity, anxiety, aggression)

Advanced training (e.g., off-leash, protection, agility)

Socialization

Walking on leash/no pulling

Other