Client Information Form

Thankyou so much for getting in touch, It would be an honour to help you & your dog on your journey towards calm together.

Filling in the information below can provide a bigger picture for me, this is so I can guide you when you need me & also means that during your consultation we can focus on providing solutions.

Name

First NameLast Name

Address (Optional)

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?

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!

How did you hear about Human Hound Healing?

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

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