New Client Intake Form

Hello, and welcome to Benevolent Sun Dogs! We are happy you have chosen to work with us, and we look forward to helping you build a solid, positive bond with your dog(s). To help us serve you best, we need to collect some basic information.

This questionnaire will be used by us to provide the best behavior modification and/or training plan for our clients. Please reach out to us at any time if you have any questions about our treatment/training protocol.

The first section will ask general questions about you and your dog that you are seeking training/treatment for. Please answer to the best of your ability.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
How did you hear about us?
Email
example@example.com
Dog's name
Dog's breed
Dog's Birthdate, if known

MonthDayYear
Date
Dog's age (best guess is fine)
How long has your dog lived with you?
Where did you obtain your dog?
My dog has a known food allergy.
Please specify

This section will ask you about any other pets currently living in your household, as well as your personal history as a dog owner.
Additional pets in the home: name, age, breed, and length of time with you:
Additional pet #1:
Additional pet #2:
Additional pet #3:
Additional pet #4:
Additional pets or more detailed information about any of your pets who are affecting/are affected by your primary dog's behavior:
If you'd like to share, please tell us about your lifetime experience as a dog owner, and any special pets who may no longer be with you but had a special impact.
This section will ask you about your dog's medical background and veterinarian.
Name of Veterinarian/Practice/Clinic/Hospital; City; length of time your dog has been a client.
Please list all medications that your pet is currently taking along with strength (mg) dose and frequency, if known. Please include over-the-counter supplements, holistic, and natural remedies.
Have you or would you consider medication to address your dog's behavioral issues?

YesNoMaybe; would need more information
Brand of heartworm prevention, if known
Brand of flea/tick prevention, if known

This section will collect information about your dog's training history.