Today's date (mm/dd/yyyy):

Your name:

Email:

Pet's name: DOB:

Breed: Color:

Neutered/Spayed: Yes No

If no, why not?

Describe birthplace of pet:

Did you view relatives of dog? If so, describe:

How old was your pet when first saw her/him?

How old was your pet when he/she first came to your home?

Why did you get your dog? (select all that apply):

Companion
To breed
Gift from someone
To show
For child
Replace another pet

If gift, from whom:

Favorite things for pet? (select all that apply):

Tug of war
Chase
Walks
Petting
Fetch
Wrestle
Car rides
Eating

Likes which type of people best? Men Women

Likes which type of people least: Men Women
Comments:

Likes which type of dog? Male Female Large Small Furry Short-haired
Comments:

Would you consider your dog aggressive with people? If yes, explain:

Would you consider your dog aggressive with dogs? If yes, explain:

Favorite treats:

Favorite toys:
Where are toys kept? Toy box Around house Hidden and out of reach Only outside in yard

What disturbs your dog? (thunder, loud noises, firecrackers, etc.):

History of seizure? Yes No

If yes, date of first seizure? (mm/dd/yyyy):

If yes, date of last seizure? (mm/dd/yyyy):

List medicine for seizures:

Is your dog taking other medications and why?

Is your dog destructive? If so, explain if types of clothing, furniture, doors, etc.:

How have you corrected this behavior? (select all that apply):

Hitting
Time out
Alpha roll
Prong collar
Newspaper
Staredown
Collar and lead
Verbal
Throwing something
Shake
Shock collar

What do you say to stop bad behavior?

What tone of voice do you use to stop bad behavior?

Does your dog bark excessively? If yes, what sets him/her off and what stops it?

Where does your dog spend most of its time?

(if inside, which room; if outside, where?)

Where does your dog sleep? Kitchen Bedroom Sofa Living room floor Garage Bed Outside Other
If other, explain:

Where does your dog have its food and water:

Who are the members of your family that live with your dog:

(list names, ages, sex, occupation):

Other pets in the family? List types and relationship with dog:

Is your dog house-trained? Yes No
If yes, how did you accomplish this?

Is your pet crate-trained? Yes No

How does she/he like the crate: Likes Hates Tries to get out Destroys Panics Barks

Can you brush your dog? Yes No

Can you clip his/her nails? Yes No

Can you clean his/her ears? Yes No

Can you bathe your dog? Yes No

Does only a professional groomer bathe/clip your dog? Yes No

What does your dog eat? Brand of food?

How much and when?

Why did you choose this brand and what other brands did you try?

Is water always available: Yes No

What else does your dog eat?

(include people food and treats):

Any known allergies? If yes, how do you know it's an allergy?

Have you owned other dogs? If yes, describe what type, how long you had them and why they no longer live with you:

Have you trained a dog before? If yes, what method did you use and how were you instructed?

Do you have a fenced yard or kennel area? Yes No

List in order of importance what you would like to change about your dog:

1.

2.

3.

4.

5.

List in order of importance what you appreciate about your dog:

1.

2.

3.

4.

5.

How have you rewarded good behavior? (select all that apply):

Treats
Petting
Verbal
Games

How much time do you spend with your pet awake during a 24 hour period?

What makes your pet happy?

What words or phrases make your dog wag his/her tail?

What words or phrases make your dog unhappy? (pet puts head down, retreats, etc.):

What type of collar(s) does your dog wear?

What words, actions or phrases do you use to attempt the following?

Sit:

Lie down:

Come when called:

Walk on loose lead:

Stop jumping up:

Where does your pet like to be touched and why?

Where does your pet NOT like to be touched and why?

List your pet's favorite people:

List your pet's favorite places:

List your pet's favorite toys:

List your pet's favorite foods:

Are you going to show your dog? If yes, explain:

This part of the questionnaire is for the owner, the pet, and the trainer. The owner's comments help the trainer understand what the owners expect from their dog and what kind of relationship the owner and the dog have at home. The trainer can then use this in the course of training to explain to the owner what a realistic goal is and what they can do to reach it. It makes it easier to explain some misinterpretation on natural behavior from a dog.

What do you like most about your dog, both physically and personality wise?

What don't you like about your dog?

What are your expectations from your dog as a dog?

Additional comments?

Signature:

Date (mm/dd/yyyy):