Client Questionnaire

Client Questionnaire

The Dog Therapist, LLC
Pet Parent Name

First NameLast Name
Pet Parent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
How did you hear about The Dog Therapist (Instagram, tiktok, Facebook, friend/family, vet)
Type of Residence*
Parking Instructions for Trainers*
Preferred Method of Communication*
Occupation
Other people living in home (Names, Ages, Gender)*
Dog Information

Please be as detailed as possible
Dog's Name*
Breed (or best guess)*
Age (or best guess)*
Weight
Sex and Status*
Is this your first dog?*

YesNo
Where was your dog obtained from?*
How old was your dog when you obtained him?
Can you describe the environment your dog was in when you got him/her? (example: in a large pet store with other dogs in kennels, in a shelter with barking dogs around, at a breeders home that had a variety of toys) The more details the better!
How long have you had your dog?*
Why did you get your dog?*

CompanionshipFor spouseFor childrenWatch dogService dogOther
Have you had professional help training a dog before (could be past dogs)?*

YesNo
If yes, where?
What did you like/dislike about prior training?
What are your current training goals? *
What cues does your dog know?

SitStayComeDrop itDownHeelLeave itNone of the aboveOther
What training methods do you currently use?

Food rewardsVerbal reprimandPraisePhysical reprimandPlayOther
What behavioral issues would you like to change?*

JumpingLeash pullingChewing inappropriate itemsPotty trainingRunning awayExcessive barkingSeparation anxietyGeneral anxietyFear of new peopleFear in new placesAggression towards peopleAggression towards dogsMulti-dog household aggressionStealing food off countersNot listeningOverarousal (extremely high energy- cannot settle)Crate TrainingPossessive of food/toys/bones/space/peopleOther
If listed "other", what other behavioral issues would you like to change?
Has your dog ever bitten a person?*

YesNo
If yes, please describe what happened (please mention if it was a nip or if they broke skin):
Has your dog ever bitten another dog?
If yes, please describe what happened (please mention how many times this has happened and describe in as much detail the situation):
Has your dog ever been bitten/attacked by another dog?
If yes, please describe what happened:
How often is your dog left alone? *
Where does your dog stay when left alone? *
Does your dog "window watch" (stares out the window during the day)?*

YesNo
Do you take your dog to dog parks?*

YesNo
Does your dog go to daycare?*

YesNo
If he attends daycare, what is the name/location of the facility?
What type of collar(s) do you use?*

flat collarfront clip harnessback clip harnessmartingale collarslip leashe-collarprong collarnot leash trainedOther
What do you feed your dog?*

KibbleRawHome madeHuman food (table food)
What is the name of the food you feed?
How do you feed your dog?*

BowlSlow feederSnuffle matKongBy hand
How many cups does your dog eat per day?*
Does your dog have any food allergies or food/treats that upsets their stomach?*
What are the top three things you LOVE about your dog?
Is there anything else I should know about your dog?*
Name of Vet*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Do I have consent to post videos/pictures of your dog on social media accounts?
My training methods follow a LIMA approach (least intrusive minimally aversive). My goal is to create a training plan focused on building a stronger relationship between you and your dog. No training is “guaranteed” since there are many variables to successful training. Please sign below to acknowledge your consent to training with The Dog Therapist.
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Client Questionnaire

Dog Information