LIFE SKILLS QUESTIONNAIRE

LIFE SKILLS QUESTIONNAIRE
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
K9 COMPANION INFORMATION
Name
Breed
Gender

Female/Intact Female/Spayed Male/ Intact Male/ Neutered
Age
Approximate weight
How long have you had this dog?
What are your dog’s favorite activities and/or games (List 3-5)
What type of food does your dog eat?
Any known food allergies?
Training History
What training have you done with this dog?
Who did the training? And what methods were used?
What do you know about positive reinforcement training?

Antecedent Arrangement Use of clicker or other marker Luring Shaping
Medical History
Who is your dog’s veterinarian(clinic name and location)
Date of last rabies vaccination:
Does your dog have any medical or physical issues? Please describe:

K9 COMPANION INFORMATION