GK9A Evaluation Form
General Information
Owner's Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Is your number textable?
Yes
No
Contact Preference
Please Select
Call
Text
Email
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this your first dog? If not, what other dogs have you owned? Please include gender, if they were fixed or not, breed, if they had any behavioral issues, and why you don't have them anymore.
What experience do you have with dog training? Please include self training, classes you've taken, if you have worked with another professional dog trainer, etc.
What is your learning style? Visual, auditory, reading/writing, or learn by doing.
Dog's Information
If you have multiple dogs, please fill out a new form for each dog
Dog's Name
Dog's Breed
Dog's Age
Dog's Sex
Intact Male
Neutered Male
Intact Female
Spayed Female
If the dog is fixed, how old was the dog when they were fixed?
Where did you get your dog? Was it a rescue or breeder? Please include the rescue name or breeder name if you remember.
How old was your dog when you first got them?
Why did you get your dog?
Companionship
Service work
Sport work
Protection dog
Other
What is your dog's training history?
Private Lessons
Group Classes
Board and Train
Online Course
Other
Where was the training done AND what was the training for?
Grade the level of training success
Bad
Okay
Good
Excellent
What will the dog do on command?
What type(s) of training equipment have you used?
Flat collar
Choke chain
Prong
Head halter
Harness
Slip Lead
Martingale
E-collar
Long line
Other
Does your dog:
Bark at people through windows
Bark at people on walks
Bark at people in your home
Bark at people in your yard
Doesn't bark at people in yard, home, on walks, or through windows
Does your dog:
Growl at people
Lunge at people
Nip at people
Bite at people
Doesn't growl, lunge, nip, or bite people
Does your dog quickly seek attention from new guests?
Yes
No
Other
Does your dog:
Bark at dogs through windows
Bark at dogs on walks
Bark at dogs in your home
Bark at dogs in your yard
Doesn't bark at dogs through windows, on walks, in your yard, or in your home
Does your dog:
Lunge at dogs
Growl at dogs
Nip at dogs
Bite at dogs
Doesn't lunge, growl, nip, or bite dogs
Does your dog cause trouble with animal housemates?
Other pets in the house? Please include their name and gender! For other dogs please include if they are fixed or not and what breed they are.
Do you use a crate
Yes
No
If yes, what type of crate?
Metal
Plastic
Mesh
Outside Kennel Run
Other
Where is the crate located in the house?
Does your dog do any of the following in the crate?
Have accidents
Whine
Bark
Excessively drool
Chew themselves
Act anxious
Break out of crate
My dog does none of these
Does your dog do any of the following when left alone?
Have accidents
Whine
Bark
Destroy things
Pace
Excessively Drool
Chew themselves
Act anxious
My dog does none of these
Does your dog have accidents in the house? If yes, when are they most likely to have an accident?
Does your dog destructively chew things they shouldn't? If yes, what do they destroy/chew?
Does your dog growl/lunge/bite over food and/or toys? If yes, what type of food or toy do they do it over? Do they do it over any other objects?(Bed/Couch/People/Doorways/etc) What behavior does your dog show over each of those objects?(growl/lunge/bite/etc)
Does your dog?
Mount pillows
Mount toys
Mount dogs
Mount people
My dog doesn't try to mount anything
Does your dog?
Dig
Counter surf
Jump on people
Run away
Pull on a leash
My dog doesn't dig, counter surf, jump on people, run away, or pull on a leash
What brand of food do you feed?
Do you free feed? (Means food is down for long periods of time or all day)
Yes
No
When is the dog fed? If you free feed, when is fresh food put in the bowl.
Who usually feeds the dog?
How many cups of food does the dog each per day? If you free feed, please give a rough estimate.
Please describe your dogs daily routine? What happens in a normal day from your dogs point of view?
What activities does your dog participate in and how often? These might include walks, fetch, hikes, chewing activities, dog sports, puzzle toys, etc.
How often does your dog spend time in the crate?
Daily
Weekly
Rarley
Never
How often does your dog spend time alone?
Daily
Weekly
Rarely
Never
How much time does the dog spend indoors? How much time does the dog spend outdoors?
Does the dog have unsupervised outside time and if so, how much? Do they have access to a doggy door?
What type of play does your dog enjoy?
What type of exercise does your dog enjoy?
Does your dog attend a dog park or social daycare?
Does your dog have any food allergies? If yes, please list them all.
Any recent changes in the health of your dog?
Is your dog up to date on their Rabies, DHLPP/DHLPPV, and Bordetella performed by a licensed veterinarian? Bordetella is only required if you are taking group classes or participating in pack walks with GK9A.
Up to date on Rabies, DHLPP/DHLPPV, and Bordetella
Up to date on Rabies and DHLPP/DHLPPV
No up to date on vaccinations, but will be getting them soon
My dog is a puppy and has the DHLPP/DHLPPV vaccination, but isn't old enough for Rabies yet
I refuse to vaccinate my dog
Describe your dog's personality
Describe your dog's behavioral issues:
When, where, and under what circumstances was the problem first noticed?
Describe the situations in which the problem is most likely to occur:
What has been done so far to correct the problem?
What was the dog's response?
Were any of the following changes in the dog's environment prior to the appearance of the problem?
Moved
Redecorated
Vacationed
Boarded
Visitors
Diet change
Change in family schedule
Lost a family member
New family member
New roommate
New pet
Other
How did these changes affect your dog?
Please select ALL situations in which your dog may show aggressive behavior?
Petting
Being approached by adults
Being approached by kids
Being in a car
Being reached for
Being punished
Being pushed
Taking it's food
Taking it's toys
Taking stolen items
Being disturbed while sleeping
Being groomed
Seeing another dog
Interacting with another dog
Other
List all medications given for behavioral issues and the results:
List all medical issues, and medications given for medical issues
If your dogs has aggression problems, explain the last two or three incidents in detail:
If your dog has a bite history, please list every bite incident in detail. What happened before the bite, during the bite, after the bite. How bad was the bite? Did it leave a mark, did it break skin, how much damage did it cause, etc
Has the dog ever had to be quarantined, been deemed a dangerous dog, or had a cival liability lawsuit?
Describe issues NOT covered above or anything else you want to mention:
Please list all human members of the household include names and ages.
What other members of your family or social network might be involved in training. Please list names and ages.
What priority does training your dog have compared to other aspects of your life?
High priority / Very urgent
Medium priority / Somewhat urgent
Low priority / Not urgent
How much time per week are you able to dedicate to training your dog on your own?
Do you have any physical limitations that need to be considered during training?
What time of day / day of the week works best for dog training?
What are you looking to improve on with training? What are your expectations of me as the trainer?
What does success with dog training look like to you?
What type of training are you looking for?
Purely positive
Balanced
I don't care: whatever is best for my dog
What training are you looking for?
Private In Home Lessons
Private Destination Lessons
Group Classes
Zoom Lesson(Video Lesson)
Online Course
Other
Are you wanting...
Obedience Training
Off Leash Training
Behavior Modification Training
Service Dog Training
Other
How is your dog's behavior affecting your everyday life?
What are you afraid will happen if everything stays the way it is?
What are your TOP 3 training goals?
Please upload proof of vaccinations: Rabies, DHLPPV/DHLPP, and Bordetella(only required for group classes/pack walks) performed by a licensed veterinarian
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I am a balanced dog trainer. This means we use a combination of rewards and corrections. Are you comfortable using a prong, e-collar, slip lead, martingale, or any other training equipment that m is best for your dog? Would you be comfortable if there was education given on the tool itself?
FOR SERVICE DOG CLIENTS ONLY: What are the tasks you are wanting trained? Up to 6 tasks may be selected.
Do you have any questions for me?
Do you have anything you want to add?
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