Client Information Form

Thankyou so much for getting in touch, i look forward to creating calm for you and your dog/s should we choose to work together.

Please fill in the form to tell me about your dog this enables me to spend more time on helping you to resolve things during our future consultations.

This will also confirm that you are aware of the importance of a veterinary check prior to beginnin behaviour therapy. When an animal has an underlying invisible illness this can affect behaviour and temperament. This often applies if behaviour change is sudden or unexpected especially in adult dogs.

Name

First NameLast Name

Address (Optional if opting for online only)

Street Address

Street Address Line 2

CityCounty/State / Province

Postal / Zip Code

Email

example@example.com

Add any other names or email addresses you may use when signing up or contacting me. This is so I know it's you.

Preferred Contact Number

What times or days are best for you when it comes to booking a one2one zoom consultation?

Do you have any health problems or disabilities that I need to be mindful of? Human Hound Healing is trauma informed, neurodiverse aware & has an inclusive policy.

Dog's Name

Dog's Sex

Dog's age & Date Of Birth?

Breed

How long they have lived with you & from what age?

Last Vet visit/reason

Does your dog have any known health issues? A veterinary check is advisable as hidden illnesses may cause a behaviour change, especially if sudden.

What is your dog currently fed on including brand names? (No judgement)

Where did you acquire your dog? Rescue or Breeder? Family member? & what background information were you given?

Any other pets in the household? Please tell me their name, brief details & ages.

How many other humans is your dog living with? Please provide brief details & ages.

How does your dog get on with other animals & family members?

What exercise & enrichment activities are you & your dog enjoying together?

Coaching & Behaviour Issues you are currently dealing with & would like resolved. Add as much information as you need to.

What have you tried so far to resolve issues? Any professional advice received?

How is this making you feel? It is perfectly normal to feel like you are struggling & also normal to feel upset. How would you like to feel? How would you like your relationship to be with your dog? The human side is just as important & you are looked after too. It is not just how they are raised, there are genetics and epigenetics to consider as well as breed disposition. All will be considered when we are creating a plan.

What would you say are your dogs triggers on walks or at home? It is advised to keep a journal of all details that you can remember. Nothing is silly. Keeping a detailed account may enable us to find a pattern.

How did you hear about Human Hound Harmony?

May we use pictures or videos of your dogs obtained in consultations, in social media, marketing or tutorial videos?

Are your dogs okay with treats? If they have dietary issues or resource guarding concerns I will arrive empty handed. If they are okay be prepared that I will be gently throwing treats behind your dog without initial eye contact.

You are welcome to send videos via whatsapp 07884368020, don't forget to give me your name and dog's the first time you use it.

Make sure videos show the environment & are not just zoomed in on the dog. The following are some ideas of helpful clips:

1: Your dog at home in their everyday environment, doing everyday normal pottering around.

2: Your dog on a walk.

3: Anything you feel would help in my assessment of issues you are struggling with.

Additional information you may want to add:

The VIP hub is designed to give you longterm affordable help. It is subscription based with no set contract, once you subscribe you will be entitled to discounted one2one consults at £40 instead of £60, you can have as many one2ones as you need.
One2ones are zoom calls, phone calls.
There is a group call via zoom on the first Wed's of every month at 7pm. This is completely free for members of the hub, all you need is a good sense of humour.
The hub is also advised due to the fact that you have access to a vast amount of information & free, self paced courses, this amount of information is not possible to give you in one consultation. You also have the 'can I just ask' option when you are worried about anything, as well as constant support throughout your progress & my advice on any videos you send. You become part of the Human Hound Healing family & can stay for as long as you need us.
For non members payment is requested in advance & details will be sent should you wish to proceed.
Paypal email moondaizee@aol.com Surname: Reeves

Warmest regards

Janeen Warman