Dog Training Form

Muttamorphosis Dog Training Intake Form

Be sure to click "submit"!
Owner/Family Information
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Please list all other human family/household members. (Or write "none.") *
Which family members will participate in the training? Even a few minutes per week helps!*
Briefly state what you hope to accomplish with training.*
Dog Information

Please focus on the dog most needing assistance. Space to discuss additional dogs, if needed, is at the end of this section.
Dog's name*
Breed/mix, if known, or best guess*
Current age*
How old was the dog when you acquired him/her?*
How long have you had the dog?*
Gender and spay/neuter status*

Female, not spayedMale, not neuteredFemale, spayedMale, neutered
Where did you acquire your dog?*

BreederIndividual with puppiesPet shopRescueShelterRehomingOther
What do you feed your dog and how frequently does s/he eat?*
How do you feed your dog?*

Always from a bowlAlways from a kong or other food puzzleSometimes from a bowl, sometimes from a kong/food puzzleOther
Please describe your dog's physical exercise and mental enrichment. (For example: two 30-minute walks per day; 20 minutes per day of yard or in-home play or sniffing/exploring with humans or another dog; dog park once a week; doggie daycare twice a week; snuffle mat 3 xs per week; long hike every couple of weeks; etc.)*
Does your dog have any food sensitivities or allergies? If so, please indicate which ingredients must be avoided.*
What does your dog absolutely love?*

Food -- any food, even plain kibbleFood, but only really good food, like meat or cheeseToys -- any toy about equallyToys, but only a certain toy or type of toyFood and toys about equallyOther
If you have dogs other than the one described above, please provide the name, age, gender, and breed/mix of each as well as how long you've had them.
Please describe food/feeding, enrichment, and exercise for the additional dog(s), if any.
If you have other pets, such as cats, please provide names and brief descriptions.
Veterinary Information

Please focus on the primary dog requiring assistance. The last question in this section provides space for additional dogs, if needed.
Veterinarian/Clinic*
Is your dog current on vaccinations including rabies? (Current rabies vaccination is required for an in-person session. If needed, we are happy to help you find low-cost options or a vet who can handle dogs with anxiety, fear, or aggression issues.)*

YesNoNo, but I have scheduled an appointment to update rabiesNo; I could use help figuring out how to get this done
List all medications your dog is currently taking. Please include heartworm, flea and tick preventatives, behavior meds (such as Prozac), and supplements (such as fish oil or Calming Care). If none, please type "None."*
Please list any medical conditions or injuries your dog has had, even if years ago. This is important as pain -- or past pain -- can affect behavior. Examples include a previous (and healed) broken bone, a current diagnosis of Cushing's disease, etc. If none, please type "None.":*
For households with additional dogs: Please indicate whether other household dogs are up to date on rabies and whether they have any medical conditions or current/past injuries. If none, please type "None."
Behavior Information

Please focus on the primary dog requiring assistance. The last question in this section provides space for additional dogs, if needed.
Please describe any previous training or behavior modification you've done with this dog (e.g., group classes, private one-on-one sessions, board n train, or online courses), or type "None.":*
What training approaches or tools have you used with this dog (even if you're not currently using those techniques or tools)?*
Level of success with prior training?*
What cues does your dog know best?*
What behavior issues or skills would you like to address?*

The basics, such as sit, down, and stayManners in the homeLeash walkingRecall (coming when called)Jumping up on owners or visitors in greetingJumpy/mouthy playful or attention-seeking behavior (play/overarousal, nonaggressive)CountersurfingBegging from humans at mealtimesBarking for attention, food, or playBarking at visitors/intrudersBarking for other reasonsExcessive fear or anxiety in some situationsSeparation anxiety (distress when left alone, with or without destructive behavior or inappropriate elimination)Destructive behavior when left alone (with or without obvious anxiety/distress)Aggressive behavior (e.g., growl, lunge, bite) directed toward unfamiliar peopleAggressive behavior toward human family membersAggressive behavior toward housemate dog or other petsReactivity: lunging, barking, or overexcited behavior (whether it seems playful, protective, fearful/anxious, or aggressive) directed toward other dogs, humans, skateboarders, or other "triggers" while on leash, behind a fence, looking out of a window, or in other circumstancesResource guarding (growling, fast gulping or guarding stance, nipping, or biting in the context of food, bed, space, or other resources)Resource guarding in which one owner may be the "resource"Other types/contexts of aggressive behavior (describe below)Other skills or behavior issues (describe below)
Please describe the unwanted behavior(s) or the skills you'd like to work on In greater detail:*
Do you use a crate?*

Yes, only at nightYes, only when the dog is home aloneYes, at night and when the dog is home aloneOnly occasionally, e.g., if the dog will be home alone longer than usualNo
Does your dog like the crate?*

Yes, the dog loves the crateThe dog seems ok with the crate but doesn't love itNo, the dog clearly does not want to go into the crate but is able to relax after a short timeNo, the dog does not want to go into the crate and is clearly distressed much of the time s/he is in itNot applicable (don't use a crate)
Describe situations where your dog appears fearful, anxious, and/or aggressive (if not described above). If your dog rarely appears to be obviously fearful, anxious, or aggressive, write "N/A."
Do you ever muzzle your dog for safety?*

YesNo
Is anyone in your family afraid of your dog? If so, please describe why and in which circumstances:*
Has your dog ever bitten a person?*

Just an air snap or growlYes, but just a nip, did not break skinYes, barely broke skinYes, broke skin, no medical attention neededYes, severe, required medical attentionNo
On how many occasions has your dog nipped or bitten a person?

Only once or twiceA few timesSeveral timesNever
Has your dog ever bitten another dog?*

Lots of noise but no apparent biteYes, just a nip, did not break skin, or barely broke skinYes, broke skin but no veterinary attention neededYes, severe, required veterinary attentionNo
How many times has your dog had scuffles with other dogs?

Only once, minor scuffleOnly once, but it was seriousA few times, but never drawing bloodA few times, drawing blood sometimesMultiple moderate to serious fightsNever
Has your dog ever been reported to Animal Control?*

YesNo
For households with additional dogs, please describe any behavior issues or skills you'd like to work on with these dogs, if time allows, or any ways in which you think these dogs may be contributing to issues or trickiness with the dog described above.
Considering all of your answers above, please describe your TOP THREE priorities for the primary dog needing assistance.*
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Muttamorphosis Dog Training Intake Form