Canine Connections Training

Handler Questionnaire
Date completed

MonthDayYear
Canine Connections Class
Handler Information
Handler’s Name
Address

Address

Street Address Line 2

City/Postal CodeState / Province

Postal / Zip Code
Email
example@example.com
Cell Phone
Dog Information
Dog’s Name
Dog’s Age
Breed
Gender
How long have you had this dog
Give a brief history of the dog before you adopted or bought him/her:
Background Information
How many family members live with the dog?
Other Pets?
Who spends the most time with the dog. Explain.
Canine Connections Training - Handler Questionnaire
Why did you get a dog?
Where is the dog allowed when you are home?
Where is the dog when you are away?
Has your dog had any formal training? Explain
Describe your dog's personality by ranking these traits on a scale of 1 to 10 (with 10 being the highest)
Hyper
Calm
Shy
Playful
Aggressive with people
Aggressive with dogs
What are your dog's favourite toys?
How does your dog react when he/she meets other dogs? Explain.
What problems does your dog have that you would like us to help solve, in priority order?
Any additional information you think would be useful for us to know?
Do you give permission for ARC to use photos of you and your dog on our website and other media? We would only include your first name and your dog's name

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I have enrolled my dog in a behaviour and training class with Animal Rehabilitation and Care Rescue Society (ARC). I acknowledge that there is an element of risk and I hereby release and forever discharge ARC volunteers, agents, and the owner of the building where training occurs, from all actions, cause of action, claims and demands whatsoever for any damage, loss or injury to person, property or animal, which may be sustained in consequence of the class taken. I certify to the best of my knowledge that my dog is in good health and has not been in contact with any infectious diseases.

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Date
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Handler Questionnaire

Canine Connections Class

Handler Information

Dog Information

Background Information

Canine Connections Training - Handler Questionnaire