Please Fill Out The Following Questionnaire

Prior To The Behavioral Consultation.

First Name *

Last Name *

Email *

Phone *

What is the best day and time to call you back? *

My schedule fluctuates during the week, so please pick the best time for me to reach out. *

9am - 11am

11am - 1pm

1pm - 3pm

3pm - 5pm

How did you hear about us? *

Are there any children at home? If yes, how many and what ages? *

Dog Information

Dog's name (or Dogs' names) *

Dog's Age/ Birthday *

Dog's Weight (approx) *

Dog's Gender *

Male

Female

Spayed/neutered? *

Yes

No

Dog's Breed or Mix *

Dog's Age when acquired *

How long have you had your dog? *

What information, if any, do you have about their previous life/parents? *

Your dog experience level? *

First time Owner
Somewhat experienced (have had a few)
Very experienced
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Any other animals in the household? If yes, what kind *

Does your dog have any of the following behaviour problems? *

Excessive barking

Excessive digging

Excessive chewing / Destructive behavior

Counter surfing

Jumping up at people

Lunging / pulling

Reactive towards humans

Fearful of humans

Aggressive towards humans

Reactive towards dogs

Fearful of dogs

Aggressive towards dogs

Resource guarding

Separation anxiety

Noise sensitivity

Please describe your dog's behavior problems and when it started? *

Please describe your training goals for your dog? *

How often and in what context do the behavior problems occur? *

What has been done to work on the problem(s)? *

Do you know whether your dog ever suffered a traumatic event? An attack by another dog or an issue with a human? If so, please explain *

Who is your dog’s Veterinarian? *

Does your dog have any known physical or medical problems? *

Is your dog on any medication? If so, please list them *

What kind of food do you feed your dog? *

Where does your dog sleep? *

What kind of exercise does your dog get on a daily basis? *

Has your dog had any formal training? *

No
Basic Classes
Advanced or specialised classes
Private trainer in home
Board and Train
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How does your dog behave around PEOPLE? *

Always friendly
Usually friendly, but cautious
Shy/scared, but not aggressive
Unpredictable
Sometimes growls or barks
Usually not friendly
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Please describe the previous training your dog experienced? *

Does your dog go to daycare or have a dog walker? *

Activities and food your dog likes? *

How long is your dog typically left alone? *

What makes your dog get excited? (toys, food, people) *

Have you experienced complaints from neighbors, landlords, police or animal control about your dog's behavior? *

Yes

No

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