Client Intake Form
for individual training sessions.
Pet Guardian Details
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Veterinary Practice Details
Name of Veterinary Practice
Name of Veterinary Surgeon you see at the practice
Address of Veterinary Practice
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of Veterinary Practice
-
Area Code
Phone Number
Insurance
If your dog is insured, please provide further details.
Who is your dog insured with?
When did your policy start?
What is your policy number?
About your Dog(s)
Name of Dog
Breed of Dog (if your dog is a crossbreed, please indicate the most prominent breed)
Gender
Is your dog neutered?
If neutered, when was this done and why?
Date of Birth (approx if unknown)
Where did your dog come from?
What age did you obtain your dog?
Has your dog been rehomed or come from a rescue?
If your dog has been rehomed/rescued, do you know the reason for their surrender?
Does your dog have any current medical problems? If yes, please provide details and a date of diagnosis and medication.
Does your dog pose a bite risk to other dogs or people?
If yes, please provide further information including the date of incidents, circumstances and how you dealt with the situation.
Early History
Have you owned dogs before? If so, what breeds have you had previously?
What was the reason for getting a dog?
Why did you choose this particular breed?
If your dog came from a breeder, why did you choose the breeder over others?
Was the litter reared in kennels, outside or in the home?
Did you meet the Dam, Sire or both? If so, please describe their temprement.
How many puppies were in the litter? If known, please state how many males/females.
How many times did you visit your dog before bringing them home?
What made you choose your dog over the others in the litter?
Describe your dog's behaviour and temperment as a puppy.
Diet
What food do you feed your dog? (Brand)
What is your dogs feeding schedule?
Who feeds your dog?
Is your dog on any supplements or medication?
Does your dog have any allergies? If so, please state below.
Would you describe your dog as a 'fussy' eater?
Exercise
What type of exercise does your dog have, duration and frequency?
Do you walk your dog alone or with other dogs?
How does your dog behave when on a walk?
Do you let your dog off the lead?
Does your dog interact with other dogs or people on a walk?
Do you take treats or toys on your walks? If so, what do you take?
Household Information
How many people are in your household? Please provide names and ages.
Are there any other pets within the home? If so, please provide further details including breed/sex/age and how your dog interacts with them.
Where does your dog have access to within the home?
How would you describe your dog's behaviour when in the home?
Where does your dog sleep during the day when you are at home?
Where does the dog sleep when you are out of the home?
Where does your dog sleep at night?
Do you leave your dog alone? If so, how long for on average?
How does your dog behave when you leave the home?
How does your dog behave when left alone within the home?
Do you provide any toys/treats/enrichment when you leave?
When you are present in the home, can your dog settle in a separate room?
Training History
What training have you done so far with your dog? e.g. training classes.
What methods have you used to train your dog? e.g. treats
How do you reward your dog when they have done something well?
How do you handle your dog when they do a behaviour that is unwanted/undesirable?
Does your dog pull on the lead?
Does your dog have a reliable recall?
Does your dog drop items when asked?
Does your dog know any other tricks or behaviours?
Do you find your dog listens more to one individual or is more obedient in different environments. If yes, please tell us more.
Identifying areas that need Support
How does your dog behave around strangers within the home and when outside the home?
How does your dog respond to familiar people?
How does your dog behave when you groom or bath them?
How is your dog behave around unknown dogs on and off the lead?
How does your dog behave around other animals such as livestock and cats?
How does your dog behave when their is a loud noise?
Describe your dog's temperment.
Areas of training that you wish to focus on.
Please describe the areas of your dog's behaviour that you are finding challenging.
How much time can you commit to training with your dog to address the current challenges you are experiencing?
What would you envisage happening if the behaviour problem persists?
Thank you for taking the time to complete the questionnaire ahead of your appointment.
If you have any questions in the meantime please contact the office via email (ellenthewoofpack@gmail.com). We are looking forward to supporting you and your dog.
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