Your details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: 0000-000-000.
Email
*
example@example.com
Your dog's details
Dog's Name
*
Breed
*
If unsure, please write mixed, and include if small/medium/large mixed breed
Age
*
*
Male
Female
*
Sterilised
Unsterilised
How long have you had the dog?
*
Where did you get the dog from?
*
What is your previous experience with dogs (have you owned dogs before, and specifically this breed)?
*
Diet
What food does your dog eat for meals (and how often)?
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Who feeds your dog?
*
How? (Bowl or other?)
*
What treats and extra food does your dog get, and in what situations?
*
Exercise
What kind of exercise does your dog get?
*
How long/often?
*
With who?
*
Household
Please list all people that live in the home and their ages
*
Please list all pets that live in the home, and please include species/breed, age, gender and whether or not they are sterilised.
*
How does your dog interact with each of the above?
*
What access does your dog have of the house/yard?
*
Where does your dog sleep?
*
Where does your dog go to the toilet?
*
Is your dog ever left at home alone?
*
If so, how often and how long for typically?
*
What are they left with to do when alone?
*
How does your dog react to/interact with visitors in the home?
*
Training History
Have you done any formal training classes? (and if so, where?)
*
How often do you train at home/on walks/outings?
*
Please list any behaviours your dog knows (e.g. sit, lay down etc.)
*
What are your dog's favourite rewards? (e.g. treats, games, toys?)
*
Does your dog have any known phobias or dislikes? (e.g. vacuum cleaner)
*
How does your dog interact with other dogs and unknown people (and how often)?
*
Is your dog protective over food/chews/toys etc.?
*
Has your dog ever bitten another dog or human?
*
Health
Who is your dogs vet
*
When was your dogs last checkup
*
Any known medical history? (incidents, medications, etc.)
*
Consult Priorities
What is the main issue you would like to address at the initial consult?
*
When did this start?
*
How often does this occur?
*
Have you noticed anything that seems to make it worse?
*
What have you done previously when it occurs?
*
Time permitting, please list (in priority order) any other issues you would like to cover. (Please include as much relevant detail as possible, regarding when these issues started, how frequently they occur, and what has been done to address it previously.)
*
Is there any other relevant information you would like to include?
*
Please detail below your upcoming availability, including what days and what time of day that you are likely to be available for a session. Please note: if you have availability during the day on weekdays I will usually be able to book you in sooner. Time slots outside of 9-5 are available, they just tend to book out further in advance.
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