Online Pet Training Evaluation

Gateway Canine LLC

Dog Training Evaluation Profile
Owner's Full Name
Physical Street Address (no PO Boxes)
City
State
Zip
Main Phone Number
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email
example@example.com
How did you hear about Gateway?
Dog's Name
Dog's Breed (or best guess of breeds)
Birthdate

MonthDayYear
Date
Age
Color/markings
Weight
MALE or FEMALE
Spayed or Neutered
How long have you owned this dog?
Where did you acquire the dog?
Is this the first dog or puppy you have personally owned?
Veterinarian Clinic
Please include all clinics your pet may visit.
Any health concerns or medical treatments we should know about for your pet?
How does your pet react to vet visits?
Please include all details to best of your knowledge. We understand Covid has had most owners outside for vet visits.
May we contact your veterinarian for more information on your pet if needed to assist in training? (For example, if there's ongoing health concerns, surgery restrictions, medications that may affect behavior, etc. You will always be informed if this is needed.)

YesNo
How often does your dog receive grooming?
Who mostly grooms your dog?
Yourself, or a profession groomer? Names, or locations not required unless helpful for training needs.
How does your pet react for grooming? Does he/she allow ears cleaned, nails clipped, brushing, etc?
How many adults over 18 live in your home?
How many children under 18 live in your home?
How many other pets live in your home? Please list species, and age
How does your dog do around the other pets in your home?
Does your home have a fenced in yard?

YesNoInvisible/Electronic Fence
Is your dog an outside dog only?
Does your dog use a crate/kennel?
Is your dog potty trained?
Where does your dog sleep?
How many times a day do you feed your dog? Do you leave food out all day?
How would you describe your dog? (Check ALL that apply)

ShyNervousJealousExtrovertedFriendlyBoredSubmissiveNeedyFearfulHyperTerritorialIndependentLazyHappyLoudFinickyAggressiveAnnoyingIndifferentPlayfulCalmDominantReactiveDestructive
Tell us more about your Dog's personality.
How is your dog around Men?

GoodNervousAggressiveUnknownOther?
How is your dog around Women?

GoodNervousAggressiveUnknownOther?
How is your dog around Children?

GoodNervousAggressiveUnknownOther?
How is your dog around Strangers?

GoodNervousAggressiveUnknownOther?
How is your dog around Crowds?

GoodNervousAggressiveUnknownOther?
How is your dog around other dogs/animals?

GoodNervousAggressiveUnknownOther?
What situations, if any, upset this dog? Think sounds, circumstances, incidents, routines:
Has the dog ever bitten anyone? Please include all incidents including those without broken skin, and with broken skin. Please include circumstances surrounding the incident.
Does your dog have a favorite food or treat? Please describe.
Does your dog have a favorite toy? Please describe.
What activities, games, events makes your dog happy or excited?
Any circumstances, situations, or background we should know about your dog?
Has your dog had any previous formal or informal training? Who/where was your pet trained, or did you self train? How long ago did they train?
What methods did you previously use when training your pet?
For example did you do clicker training, electric collar training, a mixture of positive and corrections, prong collars, etc.
Tell us more about your pet's previous training.
Did it succeed? Was it just what you wanted? Too hard? Ineffective? Etc.
What commands does your pet already use? (Check all that apply)

ComeHeelLeave ItOffStandKennelDownWaitBringGiveClimbNoSitPlaceQuietOther
How often does your dog typically respond to the commands they know?

100%75%50%25%0%
How often does your dog typically respond to the come command?

100%75%50%25%0%
What, if any, bad habits or bad manners would you say your dog needs to work on?
What are you hoping to achieve from a training program with your dog? List activities, sports, manners, commands, etc.
What type of training program are you most interested in? (check all that apply)

I want to do all the training myself.I want most of the training to be done for me.I want to do part of the training myself, but have part of it done for me as well.UnsureOther
By signing the below the owner listed above agrees that all information has been given in full, and that no information has been withheld. Any information such as aggressiveness that may put Gateway Canine LLC's trainers, staff, volunteers, and clients or the other canines at the facility in harm's way will be held at complete liability of the dog's owner's including any medical charges, legal charges, or property repairs that come from said dog. Gateway Canine has the right to dismiss any dog for untruthfulness in this evaluation.
Owner's Printed Name
Signature

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Date

MonthDayYear
Date
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