Client Information

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

TownCounty

Post code

Email*

example@example.com

Your preferred contact number *

Do you have any known health problems*

YesNo

If yes, please provide details here

Do you work? if so please detail your working hours and how long your dog is left for*

Your Dog's Name*

Age/ DOB if known *

How long has your dog lived with you*

What size and breed or type is your dog*

Sex*

Un-neutered MaleNeutered MaleUn-Spayed FemaleSpayed Female

Does your dog have the opportunity to interact with other dogs regularly (if this is something they enjoy)*

YesNON/A

What diet do you feed your dog (please include brand names)*

How many times a day do you feed your dog?*

What is your dogs approximate current weight*

What training treats do you usually use*

How many time a day does your dog poop and what is it like. For example, two times a day, a large/small handful, usually firm/soft/loose/ and light/dark in colour*

Check any of the following that exist on a day to day basis*

Provide details of any training or behavioural challenges you are currently experiencing in order of priority. So, please list the main issue first and then add any further issues in order of importance. (It may not be possible to include everything in your initial progress plan)*

Is your dog happy to wear a muzzle*

No we have'nt done any muzzle conditioningNot yet, but we are working on itYes my dog will wear a muzzle but isnt overly happy with itYes I have done muzzle conditioning and my dog is happy wearing a muzzleMy dog does not need to wear a muzzle/no bit history or aggression

Has your dog ever bitten anyone, if so please provide details of each incident below including the circumstances surrounding the bite and how severe the bite was. If not applicable, please just type N/A*

Have you previously consulted with a trainer or behaviourist about this problem*

YesNo

If so, Please provide details of the training activities and exercises you were recommended by your trainer/behaviourist. Also include details of what has been effective in seeing results and what has not been effective. If not applicable, just type N/A*

Has your dog had any negative experiences with anything or trauma in their past that you know of.*

What education and training has your dog had so far. ie - what life skills do they have - sit, down, recall, leave it, hand touch, loose lead walking, impulse control etc - & how were these taught - ie using positive reinforcement, luring, bribing, coercion etc*

Who would you say your dog trusts most in the world. Who are thy most comfortable with, most relaxed around, and most responsive to etc*

If your dog has issues, is fear or reactive towards anyone living in the same household, please provide details of those people here. If there are none, just type N/A*

When did your dog last visit a Vet*

Does your dog have any know injuries or possible injuries or ongoing health issues*

YesNo

If yes please provide details of the injury or health issues here plus any medication they are on. If there are none, please just type N/A*

Any other pets in the household*

DogsCatsOtherNo other pets

If there are other pets in the household, please provide brief details and ages here

How much exercise does your dog get each day*

0 - 30 minutes30 - 60 minutes1 - 2 hours2 hours +

How long are each of your dogs walks and in what type of location. For example - AM walk - 30 minutes on lead - street walk. PM walk - 1 hour off lead in quiet countryside walk*

Does your dog come off lead*

YesNoIn secure dog walking field

What equipment is used to walk your dog - please provide product name where applicable. If your dog is not out on walks yet please just type - Not on walks*

IE - Perfect fit harness, flat collar, choke chain, semi choke collar, 6ft training lead, Halti Head Collar, Long-line training lead.

Where does your dog sleep at night *

Where is your dog left when you go out during the day*

How many hours of rest and /or sleep does your dog get each day. Please split between night and day*

Is your dog crate trained*

Yes but they don't really like being in a crateYes and they love being in their crateNo my dog hates being in a crateNo this isnt something we have tried

Do you have any space management in place at home. ie baby gates separating rooms, or preventing your dog from gaining access to certain areas of the home*

Is your dog motivated, if so please provide details of preferences in order of most favourite to least favourite. For example - Chicken, tug rope, praise*

Does your dog like to play interactive games with you / other family members, if so what type of games do they enjoy - ie chase games, hide and seek games, fetch, tug, rough and tumble, training games, tricks etc *

What type of enrichment activities does your dog enjoy*

How often does your dog have enrichment activities ie once / many times a day / two or three times a day / week*

Does your dog have any unique quirks or preferences that you have noticed, if so please provide details here. If none, please just type N/A*

Please select the level of support you wish to book. Be aware that upon reviewing the details you provide, if we determine that the chosen level of support may not adequately address the issues you’re facing, we will offer guidance for a more suitable option.*

If there is anything else you would like to add, please do so here

How Did You Hear About The Dog Within*

Please give days/times you are available for sessions. We will try to accommodate your availability *

Does your rescue dog originate from the UK or from overseas?*

OverseasUKN/A

Name of the rescue you adoted/foster through*

Is your enquiry a rescue referral?*

YESNON/A

What date did your dog come to live with you*

Pleases give details of your dog's known history before they joined you.*

Thank you for completing the detailed pre-consult questionnaire, once you hit submit all your information will be emailed to me and I will arrange a telephone call.

AFTER OUR CALL -Once I am in possession of your video files and completed daily diary sheet, I will review all the information and formulate your initial progress plan and recommend which level of support I feel will work best for you and your dog if we have not already discussed this.

We aim to respond to all inquiries within 2 working days, but occasionally if we are experiencing a high level of demand, it may take up to 5 days.

If you have any questions please do not hesitate to email me at thedogwithin.uk@gmail.com

Kind Regards

Lorraine

Privacy Policy: In completing and submitting this form you agree with the statements made in our privacy policy and how we hold and use any data you provide. No information is ever shared with 3rd parties and we hate spam as much as you do! All our terms and conditions, privacy policy and Disclaimers are in keeping with the latest GDPR regulations.

Disclaimer: By completing this form you understand that participation in a dog training session or class may pose some risk to yourself, your dog, members of your family, or visiting guests and you assume the risk of any damage or injury incurred in attending such sessions conducted by The Dog Within

Whether we work in person or remotely you agree to minimize all risk by fully disclosing any danger or sensitivities your dog may present with and will immediately inform the trainer of any situation that may provoke aggression in your dog and be responsible for avoiding or preventing those situations.

In agreeing to participate, you agree that you and any minors attending the dog training session/s with us, whether in person or via remote video consultations waive, release and agree to hold harmless The Dog Within and any and all of its trainers and volunteers from any and all courses of actions, claims, demands, losses, injuries, and damages of any kind which may be sustained by you or your dog/s in connection with the dog training session. You understand that you shall be responsible for any indemnify and hold harmless The Dog Within and its trainers, volunteers, and representatives from and against all claims, damages, costs and liabilities in respect of any loss, damage, or personal injury sustained by you or any third party which is directly or indirectly caused by your dog.

Client Information

DOG INFORMATION

RESCUE DOGS FROM OVERSEAS AND UK ONLY

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