Dog training behavior consultation form

Emerald City Dog Training LLC

NOTE: Please take time to answer the questions bellow as accurately to your dogs daily routine as possible. This includes recent changes or incidents that have occurred. The more accurate you answers, the more accurately we can address issues or concerns you have to help get your dog trained or rehabilitated effectively and efficiently.

General Information

Pet Parent(s) Owner(s):

Date

Address:

City:

State:

Zip:

Home Phone:

Cell Phone:

Work Phone:

Email Address:

Best way to reach you:

Veterinarian:

Veterinarian phone:

How did you hear about us?

Your Pet

Pet's Name:

Breed/Mix:

Age:

Color:

Weight:

Birthdate:

Sex

Status

Age when altered:

Did you notice any short or long-term changes in the dog's behavior after altering?

Are you dog's vaccinations up to date?

Does your dog have any Medical Conditions?

If Yes, please explain:

Is your dog currently on any Medication?

If Yes, what medication:

Describe your dog's diet:

If Wet or Dry, please provide Brand and amount:

If RAW, please describe:

Where did you acquire your Dog? (Breeder name, Shelter name, Pet store etc.)

Behavior of parents or litter mates:

Environment/Lifestyle

How old was your dog when you got them?:

Has the dog had previous owners? If yes, please explain:

How does your dog spend the majority of their time?

How often does your dog get exercise?

Briefly describe your dog's exercise routine:

Has your dog been Crate trained?

Do you still use the Crate?

How many hours a day is your dog kept in the Crate?

Family Relationships

List each family member, include sex and age:

Has your household changed since acquiring your dog?

If Yes, please explain:

Does your dog enjoy children?

If No, please explain:

List all other pets, including breed, age and sex:

Please describe your dog's interaction with other animal in the household:

Describe how your dog reacts to guests and strangers:

Describe your dog's behavior around other dogs (or other animals):

Training

Has your dog had obedience training?

If Yes, it was:

What training school or professional trainer/ Behavorist did you use?

Do you know what training methods the trainer used?

If Yes, please explain:

Briefly describe your impression and benefits from training:

Please describe the main problem or problems that made you feel like training was the next step in your dogs journey?:

How would you describe the severity of this problem?

How often does the problem occur?

Anything else you would like us to know?

Notes: