• Behaviour Assessment Consultation Form

  • Thank you for your interest in learning more about your dog and their behaviour. Understanding our dogs is the foundation of our communication. Our behaviour consults is about learning about you and your dog. ALL aspects of both you and your dogs day to day life are taken into consideration from their behaviour, to what they eat, to the way they move, sleep. We collect the basics here and learn more when we meet.

  • Format: (000) 000-0000.
  • Is your dog?*
  • Have you done any training with your other dogs?*
  • Where does your dog stay while you are Home with them?*
  • Where does your dog stay while you are NOT HOME?*
  • Does your dog get foraging toys or activities daily?*

  • How many minutes a day do you:

  • Life Style Questions

  • How often do you take your dog to the park?*
  • What percentage is your dog calm on a daily basis?*

  • Behaviour and Training

  • Does your dog respond to any of the following loud noises?*
  • If your dog responds to noises what does it look like?*
  • If your dog responds to humans what does it look like?*
  • Other typical reaction when seeing or meeting other people?*
  • If your dog responds to other dogs what does it look like?*
  • Other possible reactons when seeing or meeting other dogs?*
  • Check off any training methods you have used with your dog.*
  • Please check all that apply to your dog.*
  • Check skills you would like to learn*
  • Are you and your family ready to make real life changes that will help affect your dogs training and behaviour? Training and behaviour change does take time to have an effect, and you will want to consider right now that training is going to become part of your routine. Are you ready? If you are then I am so happy to be chosen to help you and I will be committed to you in you and your dogs learning.*

  • The Process

    Thank you for your time with our questionnaire. After filling out the questionnaire, I will review, it will be put into your file and we can schedule your consultation. Part of the assessment process includes taking more history, a functional assessment which allows me to fully complete my assessment. If you would like this part competed, I will send you the PDF form that has all the instructions. If you want a functional assessment you will need to do this part yourself to cut down on costs. To complete this process will involve an extra cost. Behaviour Issues can be linked to physical issues and my behaviour assessment helps us determine that we ask that you let your veterinarian be involved in order to rule out any medical issues that could be the cause. Behaviour and medical issues can be closely linked. Annual check-ups do not always look for issues unless you specifically let your veterinarian know. ( Pain/discomfort can be linked behaviour issues, up to 80% of behaviour issues) The initial in-home consultation will take approximately 60 - sometimes 90 mins. After our first visit, I will put together a training plan to meet you and your dog’s behaviour goals which may or may not be adjusted depending what information is collected prior, during the first session and at each subsequent session as well as what is happening in between sessions while you are working with your dog. It is not uncommon for adjustments to be made.
  • Do you agree in getting your dogs health and medical check up?*

  • Liability Waiver, Termination and Training Policies

    Sylvia Koczerzuk will endeavor to create a safe, healthy environment for the training of my dog(s) and will offer only safe, ethical, responsible and scientifically-sound training suggestions and lifestyle recommendations. Sylvia Koczerzuk, CDBC trains with science-based positive reinforcement techniques. I am a Force-Free Trainer I am informed by science, buided by empathy, governed by ethics! I expressly and voluntarily assume all risk of injury while training my dog(s). I recognize that while Sylvia Koczerzuk is responsible for the unintentional errors, omissions or incorrect assertions. I understand that the recommendation of any other product or service is not a guarantee of my satisfaction. Further, I am and will remain responsible for the actions of my dog at all times, and I hereby agree to indemnify and hold harmless Sylvia Koczerzuk and , of any and all claims of injury, expenses or damages caused by the actions of my dog while under Sylvia Koczerzuk instruction, the care of Sylvia Koczerzuk or under my own care as a result of following the training plan. I understand the inherent risks of owning a dog, including but not limited to, the risk of dog bites to other animals, other people or myself. I understand the behaviour of a moment-to-moment decision-making animal can never be guaranteed. Therefore, the success of my dog(s) is highly correlated to the amount of time I spend practicing the desired behaviours with my dog(s) and the degree of consistency family members and I employ. I realize that my success is contingent on my family’s dedication to working with our dog on a daily basis. There are no guarantees with behaviour modification, and I will not hold Sylvia Koczerzuk responsible if my dog does not meet our training goals.

  • The Client agrees to assume full legal, financial and moral responsibility for the actions of their pet(s). The Client further expressly waives any liability arising from the generally accepted canine training practices and procedures employed by Sylviia Koczerzuk of Walkabout Canine Consulting. The Client(s) agree that my/our heirs, assignees and legal representatives will not make claim against, sue, or attach the property of Sylvia Koczerzuk and Walkabout Canine Consulting, its owner, relatives of its owner, assigns, agents or representatives, acquaintances, or any other person acting on behalf of WCC (hereafter referred to as “Agents”), for injury or damage to or by pet(s) resulting from an act or omission, however caused, by Sylvia Koczerzuk and Walkabout Canine Consulting.  of client(s) The Client(s) forever release Walkabout Canine Consulting and it’s Agents from any and all liability and demands which the Client(s), and their heirs, assignees and legal representatives may have or may hereafter have for injury or damage to or by pet(s), and assume all risks thereof.

  • Termination of Service: WCC is fully committed to providing Client(s) with the tools they need to forge a positive and lasting relationship with their pet and has devoted over 30 years of pet care and behavioural studies to achieve that goal. Occasionally, Clients do not provide the necessary degree of commitment to the training process to facilitate positive results. In those rare circumstances, the training is unlikely to succeed notwithstanding the best efforts of WCC. If, at the sole discretion of WCC, the Client(s) is found not to be committed to the work involved for behaviour change, WCC reserves the right to terminate the contract and refund any outstanding balances to the Client(s). If however the client chooses to discontinue services for no reason before completion date there will not no refunds for sessions purchased.

  • Dispute Resolution:

    The Client(s) and WCC hereby agree to mediate and/or arbitrate any misunderstandings that may arise pursuant to the terms contained herein. In any action or proceeding arising out of this agreement, the prevailing party reimbursement shall be limited to actual costs and expenses incurred.

  • Media Release Heading

    By checking the "I agree" box below, I hereby give my full consent to all photographs, audio recordings, video recordings and/ or academic work taken of me, my dog(s), friends and family members (including minor children) by Sylvia Koczerzuk, or their designee. I understand that any such photographs, audio or video recordings, and academic work become the property of Sylvia Koczerzuk, and may be used without consent, for instructional, educational, or promotional purposes as determined by Sylvia Koczerzuk in broadcast and electronic media formats, now existing or in the future created.
  • Check below*

  • Release for Veterinary Information Purposes: Heading

    The Client(s) agree to allow Sylvia Koczerzuk at Walkabout Canine Consutling to contact my pet’s veterinarian to discuss behaviour and medical history.

  • Cancellation Policy

    By checking the "I agree" box below, I understand and agree to the following cancellation policy terms: 1. Once a training program has started, there are NO refunds. 2. The client may reschedule or cancel ONE prescheduled private session without penalty. Any subsequent reschedules or cancellations will count as and be charged as a prepaid session in the training plan. It is imperative that sessions be scheduled on a consistent basis and in a timely manner. 3. A minimum of 48 hours notice is required to cancel a scheduled session without penalty. 4. When a client chooses not to continue the remainder of the training session, there will be NO REFUNDS.

  • Any prepaid in person sessions must be used within a period depending on the amount of sessions package paid for. 3 session prepaid must be used within 2 months and 5 prepaid session must be used within 4 months. Larger programs can be used over a  longer preriod. Online/Hybrid programs that include in person will and can be replace with Virtual meeting at our discretion. Any sessions not pre-booked at time of last meeting will be up to the CLIENT/PAYEE to schedule and reschedule appointments except for the SA program which must be booked after each reassessment. This policy help both of us. Once you sign up there are NO REFUNDs.

  • Those participating in any group classes that miss a week will not be reimbursed nor given any compensation for any missing class.

  • Payment Policy

    By checking the "I agree" box below, I understand and agree to the following payment policy: Payment via E-Transfer to walkaboutcanineconsulting@gmail.com is DUE IN FULL upon booking of services.

  • Contract Review

    By checking the "I agree" box below, this contract is validated, and approval for future services without additional written authorization. I have read and agree to the terms of this contract and Policies. I also understand that the desired outcomes for my dog’s training and behaviour is directly proportional to the time, commitment and positive reinforcement technique spent working with my dog in between training sessions.
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