Intake Form

Intake Form
Owner information
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityCounty

Eircode
Phone Number
Children in the house under age 18?
If yes, names and ages of all children
Information about your dog
Dog's Name
Age / Date of Birth
If known
How long have you had the dog?
Sexual status
Breed (or cross-breeds if known)
Where does the dog eat?
Brand dog food
Dog's main food source (tick all that apply)

Other
What times does s/he eat?
Does your dog have any food allergies
Please list any known allergies
Does the dog finish the meal straight away?
Is anyone (or other pets) nearby when the dog eats? Who?
How many walks per day/week
How long is each walk?
Play during the day

Other
How long does the dog get played with every day?
What would you like your dog to learn to do

Other
Anything you would like the dog to learn not listed above
What would you like your dog to stop doing

Other
If you selected Biting, barking, lunging or growling, please describe in detail when these are happening
You may be asked to fill in a behavioural questionnaire based on your answer
Anything you would like your dog to stop not listed above
What equipment are you currently using

Other
What are your dog's 3 favourite snacks/treats
What are your dog's 3 favourite toys/game
What enrichment toys/food puzzles do you have (eg., Kong)
if any
What tricks/cues/commands does your dog already know

Other
How were these taught (select all that apply)

Other
For unwanted behaviours, what happens right before the dog does it?
eg., someone walks past window then the dog barks, or visitor arrives at door, dog jumps
Please describe your dog's day in detail from waking in the morning to going to sleep at night. Include toilet breaks, play, walk, naps, time left alone, etc.
Where did you hear of us
Should be Empty: