• The Good Steward Training Company's Behavior & Welfare Pre-Consultation Questionnaire

    We appreciate you taking the time to fill out this form thoroughly! This form provides us with the necessary information to best serve you and your animal companion. Please answer ALL of the questions in this form. If something does not apply to your animal companion, please note this in the answer box.
  • Getting to Know You

  • Format: (000) 000-0000.
  • May we text you at this number?
  • I am seeking assistance because my animal companion:
  • Getting to Know Your Animal Companion

  • What is their sex and status?
  • If you are seeking welfare and behavior assistance for more than one individual, please fill out a separate form for each.
  • Medical History

  • Do we have your permission to request your pet's medical records from this vet?
  • Is your animal companion up to date on their rabies vaccine?
  • When was your animal companion given their most recent rabies vaccine?
     - -
  • Was this a 1 year or 3 year vaccine?
  • What is your animal companion's heartworm status?
  • When was the date of their last heartworm test?
     - -
  • Does your animal companion have any food allergies or food sensitivities?
  • During vet visits my animal companion
  • Does your animal companion have any current illnesses or injuries?
  • Does your animal companion have any chronic or reoccurring medical issues?
  • Has your animal companion had any previous illness, injury, or medical issue that required veterinary treatment?
  • Has your animal companion had any surgeries besides their spay/neuter?
  • Has your animal companion ever been assessed for pain, had a pain trial, or had a gait analysis?
  • Besides their monthly preventative, is your animal companion on any current medications?
  • Has you animal companion previously been on medications that are no longer is use?
  • Developmental History

  • When did your animal companion join your family?
     - -
  • How did you acquire them?
  • If you got your dog as a puppy, were you able to visit them before the age of 10 weeks?
  • Were you able to meet your animal companion's parents?
  • If your animal companion was older than 16 weeks (4 months) when you brought them home, were you given any information about their prior life experiences?
  • Environmental History

  • Do any of the other animal family members have behaviors of concern including general anxiousness, storm anxiety, over-arousal, reactivity, resource guarding, etc?
  • Do you have family, friends, or other professionals (such as a dog walker) who assist in caring for your animal companion or watch them while you are out of town?
  • We live in a:
  • If applicable, we live:
  • If applicable, our development includes:
  • We have a:
  • How long has your animal companion lived at their current residence?
  • I currently feed my animal companion
  • I provide most meals (75%) in:
  • They usually eat:
  • What do you and your animal companion do for fun on 4 or more days of the week?
  • When it comes to play, my animal companion likes:
  • How long do these walks typically last?
  • How much time on the walk does your dog typically spend sniffing, chewing, rolling, and otherwise actively engaging with the environment? (Ex: 50%)
  • What tools do you currently use to walk your dog?
  • I carry treats on our walks
  • I feel confident that I can currently safely control my dog on a walk
  • I have anxiety about walking my dog
  • What best fits your dog's response when they see a person during their walk?
  • What best fits your dog's response when they see a dog during their walk?
  • On walks, my dog has a notable response to
  • Social History

  • What best describes your dog's behavior towards other dogs?
  • I currently or used to take my dog to doggie day care or local dog-centric hangouts
  • If you answered yes to the question above, please select the option that best describes your dog's behavior while at these locations
  • Has your dog ever gotten into an altercation with another dog OUTSIDE of the home?
  • Has your dog ever gotten into an altercation with another dog WITHIN the home?
  • Over time the altercations have
  • Over time the altercations have
  • Do you feel you can identify the primary trigger(s) causing the altercations?
  • What best describes your dog's behavior towards people?
  • Does your dog respond differently towards strangers if they encounter them in different places? For example, do they act differently towards a person coming into the home versus a person at the store?
  • If you answered yes to the question above, where does your dog seem most comfortable?
  • Has your dog every displayed rapid deep barking, growling, lunging, or snapping towards a non-family member?
  • Over time these behaviors have
  • Over time these behaviors have
  • Has your dog every bitten a non-family member
  • Do you feel you can identify the trigger(s) that led to these incidents?
  • Has your dog ever displayed rapid deep barking, growling, lunging, or snapping towards a member of the family?
  • Over time, these behaviors have:
  • Over time, these behaviors have:
  • Has your dog ever bitten a member of the family?
  • Over time, the bites have:
  • Over time the bites have:
  • Do you feel you can identify the trigger(s) leading to these incidents?
  • I feel like my dog is unpredictable
  • Behavioral History

  • Have there been any instances of urination / defecation in the home since potty training was completed?
  • Have there been any instances of destructive behaviors in the home since house training was initially completed?
  • When we are away from home my animal companion is:
  • When we are away from home my animal companion seems:
  • I have a camera that I use to monitor my animal companion when I am not home
  • When it comes to the crate, my animal companion
  • If I am on the other side of a pen, baby gate, door, window, etc from my animal companion they
  • During storms and/or fireworks my animal companion seems
  • When my dog is eating their regular food, if I am nearby or approach them they will:
  • If my dog has a high value treat, such as a bone, and I am nearby or approach them they will:
  • If my dog is laying down with a toy, and I am nearby or approach them they will:
  • My dog exhibits these behaviors towards other dogs in the home
  • I feel my dog may demonstrate tense body language, growling, snapping, or biting if:
  • Training History

  • I have tried to teach my dog:
  • I or a trainer have used these tools while teaching my dog:
  • I feel like my dog:
  • Training Agreement

  • Media (photos of videos) of my animal companion taken during training can be utilized by the Good Steward Training Company on their social media platforms, website, and in educational or presentational materials.
  • Non-Staff including mentees and other trainers who adhere to the ethos of The Good Steward Training Company may assist with my dog's training:
  • I understand that The Good Steward Training Company is providing guidance and support in regards to my animal companion's welfare and behavior. While they will be training my animal companion directly, I understand that the progress my animal companion makes is heavily impacted by my cooperation and effort and that the long-term success of my animal companion is contingent upon my continued willingness to provide them the support and guidance as instructed by my behavioral modification coach.
  • I acknowledge that behavior is dynamic, learning is always taking place, and the day-to-day choices of my animal companion are influenced by many variables. I understand that, because of the nature of behavior, The Good Steward Training Company cannot make any guarantee regarding the outcome of any modification program. I understand that we may uncover information about my animal companion that requires additional work with a vet or vet behaviorist.
  • My coach my find it necessary to my animal companion's wellbeing and behavior success that I acquire items such as treats, enrichment puzzles, a muzzle, leashes, harnesses, or medication. I understand that I am responsible for the cost of these items, and that if I decide not to acquire recommended or necessary items it will impact my animal companion's welfare and/or success.
  • My dog has exhibited aggression towards people prior to the date this form has been submitted.
  • My dog has exhibited aggression towards other animals prior to the date this form has been submitted.
  • Given my dog's history of aggressive behavior, I understand that they are now or may become a risk to the safety of others even with the behavioral support of The Good Steward Training Company. I am electing to seek behavior modification for my dog even though the exact outcome of this program cannot be guaranteed. During and after our work together, The Good Steward Training Company LLC can only be held liable for my dog's behavior during times in which my dog is being handled by or in the direct care of The Good Steward Training Company. I acknowledge that I am solely responsible for any damage my dog inflicts upon an animal or person at any and all other times.
  • I understand that withholding information about my dog's prior behaviors and experiences puts others, including employees of The Good Steward Training Company and members of the public, at risk. I accept complete responsibility and liability for any harm that occurs as a result of lack of disclosure prior to training.
  • I understand that the initial consultation will be billed individually and does not promise any further services by The Good Steward Training Company. I acknowledge that The Good Steward Training Company has the right to refuse services to me at any time for any reason not protected under discrimination laws.
  • The Good Steward Training Company will always act in good faith. They agree to bring any disputes or concerns to me in a prompt manner. They agree to seek resolution through mediation prior to doing so through litigation. I agree to act in kind - to bring disputes or concerns directly to them in a prompt manner and to seek resolution through mediation before taking legal action.
  • The Good Steward Training Company has a professional duty to provide a safe environment for my animal companion during learning. I agree that the Good Steward Training Company is only liable for harm either to or caused by my animal companion in cases where negligence on the part of The Good Steward Training Company can be proven.
  • I understand that the terms and conditions set forth in this agreement cannot be modified or changed in any way after I submit this form unless the modification is agreed upon with witnesses and in writing by both parties. I have read and fully agree to all terms and conditions.
  • Thank you for taking the time to fill out this questionnaire! We are honored by your choice to trust us with your animal companion's welfare and behavioral modification. We look forward to helping you succeed!

  • Should be Empty: