Dog Behavior/Training Certificate Request
Thank you for your interest in learning more about behavior and/or training help for your family. Please fill out the following questions so we can learn more about your family and your pet.
Part 1: Household
Your name:
*
Your email address:
*
Phone number:
*
Dog's name:
*
What gender is your dog?
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Female
Male
I don't know
Is your pet spayed/neutered? (Had a surgery so it can not reproduce?)
Yes
No
Dog's age:
How long have you had your dog?
Why are you requesting behavior/training help for your pet? Please provide as much detail as possible.
*
Describe your household.
Quiet
Active
Noisy
Are there other animals in the home?
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Yes
No
What type of other pets do you have?
Cats
Dogs
Are there children in your home?
Yes
No
I don't know
What ages are the children your home? (check all that apply)
0-1 year old
1-6 years old
6-15 years old
15 years and older
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Part 4: Behavior Background
Have you ever worked with a professional dog trainer before with this dog?
Yes
No
What type of training method did you use?
Training tools (shock collar, prong collar, bark collar)
Just treats and lots of pets
A mix of training tools and treats
What issues do you want help with most?
Barking
Jumping
Destructive in the home
Mouthy (Nips/chews on your hands/arms when they get excited)
House soiling
Reactive when they see people/other animals walking by your house
Reactive to other dogs when you're on a walk
High energy/ Can't wear them out
General obedience (sit, stay, down)
Help with relationship between dog and children
Destructive/nervous when left alone (separation anxiety)
Walking on a leash
Check all that describe your dog's personality (Check all that apply):
Playful
Couch potato
Lap dog
Affectionate
Destructive
Shy
Aggressive
Independent
Talkative
Friendly with visitors
Shy with visitors
Uses mouth/jumps up in play
Does your dog chew on an of the following?
Doorways
Shoes and other personal items
Their toys
Furniture
Does not chew
What words does your dog understand (check all that apply):
Sit
Stay
Down
Come
Leave it
Drop
Wait
Heel
Off
Please check all that frighten your dog:
Doesn't seem afraid of anyone
Babies or toddlers
Teenagers
Women
Men
People in uniform
Loud voices/yelling
Sudden movements
Unpredictable children
School-aged children
Men
Strangers/visitors
Veterinarian/groomer
Fireworks/loud noises
Water
Car rides
What does it look like when your dog is frightened?
Has your dog ever bitten?
Yes
No
Please describe the time your dog has bitten in as much detail as possible.
Has your dog ever snapped at a person or other animal?
Yes
No
Please check all that apply to the time or times your dog has snapped:
at a child
at an adult
at another dog
at a cat
How does your dog play with other dogs?
Will play with other dogs
Picky about the dogs they like
Plays rough with other dogs
Does not enjoy playing with other dogs
Hangs out with other dogs rather than plays
Chases or herds other dogs
Prefers dogs that are gentle or indifferent
Barks constantly
What is your dog's favorite thing to do?
How does your dog do on leashed walks?
Great
Pulls a little
Pulls very hard
Doesn't go on leashed walks
Is this dog possessive or protective?
Yes
No
What is your dog possessive or protective of?
people
food
toys
other dogs
What does it look like when your dog is being possessive or protective?
Please list any other information it's important for us to know about your dog!
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