First Name *

Last Name *

Pronouns

Email *

Phone *

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Address

Street Address

City

State

Country

Postal code

Please list everyone in household including ages

Are there any other pets in the household? If yes, please specify species/sex/age

Have you had a dog in the past?

Are you considering returning, surrendering or rehoming your dog?

What are your long-term training goals for your dog?

Dog's Name *

Dog's Age

Dog's weight

Dog's Sex:

Spayed/Neutered

Age when spayed/neutered (if known):

Where did you acquire your dog?

Dog's Breed

How long have you had your dog?

Does your dog have any known physical or medical issues?

If your dog has any known physical or medical issues, please explain:

Is your dog currently taking any medications?

If your dog is currently taking any medications, please list what medications:

Please list what type(s) of exercise your dog gets on a regular basis:

How many times per day do you feed your dog?

Have there been any incidents of your dog snapping or attempting to bite? If so, please describe

Please describe your dog's behavior problem(s) in more detail:

When were these issues first noted?

How often do these issues occur?

Have you attended obedience classes with this dog or any other previous dogs?

Have you previously enlisted the help of a trainer, behaviorist, or veterinarian for your dog's behavior?

If you have previously enlisted the help of a trainer/behaviorist/veterinarian, when, where, and for what behaviors?

How have your previously tried addressing the issue(s) and how has your dog responded to these methods?

My dog enjoys (select all that apply):

Food/Treats

Toys/Play

Attention

Other

Is there anything else you would like us to know about your dog?

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