Name
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First Name
Last Name
Email
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Address where training will take place
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Phone
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(###)
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Dog's name
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Dog's breed
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Dog's age
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Has your dog ever growled, lunged, snapped, or behaved aggressively towards any person or animal? Please explain
(this is for any behaviour other than bites, which are covered in next question)
Describe each bite separately. Categorize each bite as one of the following 1) BIte 2) Bite & Hold 3) Bite, Hold & Shake. Include location on victim, lead up circumstances including dog body language or warnings, how the attack ended and any injury to person or dog.
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Description of other behaviour issues currently concerning you
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What age was your dog when you acquired him/her?
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Where did you acquire your dog?
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Please list any other dogs in the home (name/age/breed/sex)
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Date of last rabies vaccination and veterinarian that administered
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Please provide the name of your current veterinarian
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Does your dog have allergies? if yes, please list.
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Recent changes in dog's health? (handling/ear/skin/lethargy/sensory changes/medication/appetite/weight)
Please describe any recent injuries or illnesses your dog has experienced. List any medications (past/current) surgeries, nutrition issues, or other medical info.
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Please list any adults/children/other pets in the home
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Please describe the home layout including what areas your dog has access to or is prohibited from. Kennels/crates, and a description of the exterior (fence types, security, neighbours)
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Please describe your dog's routine ( i.e. left alone during work, dog walkers, daycare, dog parks etc) as well as any environmental stressors (neighbour dogs, deliveries, visitors etc)
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Please describe your dog's social history. (How many people are in their inner circle, other dogs, other animals)
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Please describe your dog's enrichment history. Type of exercise, frequency, other activities. What does your dog enjoy?
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Please describe your dog's training history. Include any classes, other trainers, type of training
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Please describe any methods of training you are familiar with or have tried. Include how you feel about those methods (success/challenges)
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Please describe your dog's reinforcers (food, toys, walks, attention)
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What cues does your dog currently know (will perform on command the majority of the time?)
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What behaviours are common from your dog (jumping, barking, pawing, mouthing, nipping, etc)
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