Training Behavior Questionnaire

1
The Family
First Name
Last Name
Occupation
2
Email
example@example.com
3
Phone Number
Area Code
Phone Number
4
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Best time to contact you (Weekday/weekend and time?)
6
Preferred way of contact
Email
WhatsApp
Phonecall / Text msg
FB messenger
7
Name
8
Your dog
Breed
Gender
Age
Date of Birth (exact or estimated?)
Weight
Other pets in household?
If yes, - Details
9
Spayed/Neutered?
YESNO
10
If YES. When did this occurred?
11
Is your dog up to date on vaccinations and protocols as recommended by your Veterinarian?
YESNO
12
Allergies or medications?
YESNO
13
If yes, Please describe (include any medications and supplements)
14
Please describe any past or present medical or health conditions or important medical history (injury, trauma etc)?
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Small
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Ok
15
When was your dog last at the Vet and why?
16
Any physical or behavioural limitations, that can impact your dog's ability to participate in Canine Conditioning Program?
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Ok
Ok
17
What is your long term goal you would like to achieve for you and your dog?What would you like your dog to be able to do. If multiple - what is your priority?
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Ok
18
What are your short term goals you hope to achieve by participating in this program?
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19
Training historyWe would like to know if we are building up on previous skills or training methods, or starting from the begining
Did you attend training school or work with a trainer before?
Are you still attending?
What have you learned
What behaviours your dog knows well
Do you do any training yourself
20
What are your dog’s favourite rewards? What would your dog sell you for? Food, toy or attention? Please be specific
21
How does your dog react when being handled?
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Ok
Ok
22
What happens when visitors come to your home?
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Ok
Ok
23
What do you like about your dog?
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Ok
Ok
24
Your dog's Diet
What type of food does your dog gets
Feeding schedule?
What amount per day?
Any treats and snacks?
25
What kind of exercise your dog gets and how often?Please include any activities your dog is involved in
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26
Do you currently own or have access to fitness / exercise equipmentPlatforms, treadmill, peanut, fit-bone inflatables, balance cushion etc.
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Small
Ok
Ok
27
Any additional information you would like me to know?
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Ok
28
Thank you for taking the time to complete this form. Consider recording any incidents in chronological order and recording any new information and share with us before or on the day of our next session.
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