Pet Behavior Counseling Profile
Sue Schulze, CPDT-KA cell 314-607-1913
sschulze@kennelwood.com
Name
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First Name
Last Name
Phone Number
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Area Code
Phone Number
2nd Cell or home phone
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Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Pet’s name
Breed and Age
Male or Female? Is your dog spayed or neutered?
Vet Clinic used
Vet clinic
List any medical conditions your dog has/had. And any current medications
Rabies inoculation date and is it 1 yr or 3 yr shot
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Month
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Day
Year
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Age of dog/puppy at adoption
Where did you get your pet?
List other pets and info
Do you use a crate?
Where does your pet sleep at night?
Where does your pet stay when you leave the house?
How often do you feed your pet? For example: 2 times a day or free feed all day
What kind of food?
Do you give treats? What kind?
Do you have a fenced yard?
How often do you walk your dog?
What kind of leash and collar/harness do you use?
Does your dog walk well on a leash?
How does your pet behave for grooming or vet visits? Any biting? Struggling? Shaking? Etc.
Does your dog have to be muzzled or sedated at the vet or groomer?
Has your dog ever, to your knowledge, bitten another dog or person? If yes, provide details (which will be kept confidential).
Has your dog had previous formal training? If so, please describe.
Describe what behaviors you are seeing with your pets. Any problems? List any commands/behaviors you would like to train.
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Month
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Day
Year
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