Canine Enrichment Co Assessment Form
We kindly request that you take ample time to complete this form. It is designed to help us better understand your canine companion and your needs and to ensure we are prepared for our consultation. Your attention to detail is greatly appreciated and will greatly assist us in making the necessary preparations. Thank you in advance.
The Human End of the Leash
Full Name
First Name
Last Name
Co-Guardian's Name (if applicable)
First Name
Last Name
What are your pronouns?
Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
Co-Guardian's Number (if applicable)
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Email Address On-File
example@example.com
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please provide any needed neighborhood or parking instructions
ex. gate code, guest parking, street parking
Who is your primary veterinarian?
Please indicate the practice name (ex: Blue Pearl / Urgent Paws / Etc )
How did you hear about us?
What are your hopes/expectations for our program and for you and your dog?
What is your favorite thing about your dog?
What activities do you do or want to be able to do with your dog? (ex: rv travel, paddle-boarding, patio buddy...)
What Services Are You Interested In?
Enrichment Services
Training Services
The Best of Both Worlds
I'm Not Sure Yet
What are your short-term training/behavior/ enrichment goals?
What are your long-term behavior/training goals/enrichment goals?
Do you have any immediate concerns/something(s) you'd like to prioritize?
How much time do you currently spend physically exercising your pup on average?
What activities do you normally facilitate (more often than not) to provide physical exercise and for how long?
Ex: Fetch - 25 minutes 2x a day / neighborhood walk- 30 mins
How much time do you currently spend on enrichment for your pup each day on average?
What activities do you provide/encourage that you feel enriches their life?
ex: sniffy walks, hiking, swimming, digging, food puzzles, chewing on bones/stuffed kongs, tearing up boxes, snuffle mat, agility, barn hunt, nose work...
Let's Get to Know Your Pup Better
Dog's Name (and any regularly used nicknames)
How old are they?
How old were they when you acquired them?
How did you acquire them?
Please be specific. Ex: Humane Society, SPCA, Breeder's Name Here
Breed(s) / Best guess
What is their bday/gotcha day?
If you have a photo of your pup, drop it below :)
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How much do they currently weigh?
Has your veterinarian provided any feedback on your dog's weight? If yes, please explain.
Have they been spayed/neutered? If yes, how old were they when spayed/neutered?
What flea/tick & heartworm preventatives do you use?
Upload Your Dog's Most Recent Vaccination Records
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What are your pup's favorite things to do?
Ex. Swimming, digging, shredding, running, fetching, car rides, chewing, etc
What does your dog eat at mealtime? Please provide brand name & quantity.
If they are raw-fed, please be detailed
Does your dog have any allergies (environmental, food, medication) or food sensitivities?
Would you consider your pup to be a picky eater?
Is your pup allowed to have long-lasting chews (bully sticks/marrow bones/no-hides/beef tracheas)
Is your pup allowed to have stuffed frozen Kongs?
Does your pup have a history of eating (ingesting) non-food items? If yes, please be specific
Ex: Socks, underwear, rocks, mulch
Does your pup have a history of resource guarding? This includes food items, toys, people, locations (like beds/sofa) towards other dogs or people? If yes, please explain.
Has your pup ever jumped a fence? If yes, how tall was the fence & what type of fencing was it?
Do they have any known medical/physical conditions or limitations to be aware of?
Does your pup have any growths, lumps, or skin issues we should be aware of? If yes, what and where on their body?
Are there any areas of their body that your dog does not like being touched/handled?
Has your dog experienced any trauma to your knowledge?
ex: time in shelter/cruelty by people/attacked by another dog or animal/etc
How does your dog behave when they are left alone?
How would you describe your dog's behavior at home? Select all that apply
Laid Back - happy to lay around/goes with the flow
Bored - perhaps destructive?
Busy - always looking for something to do (for better or worse)
Energetic - they keep us active and on our toes
Anxious - uneasy/unsure of some household situations
Sensitive - certain noises, interactions, activities are overwhelming
Alert - quick to notice and react to shifts in/around the environment
Aloof - likes to spend time away from the action/less interested in cuddling or interacting
Cuddly - regularly seeks out physical touch
Wild Child - it's hard to keep up with them/keep them out of trouble
Velcro - they would live inside my skin if they could
Shadow - Where ever you go, there they are
Introverted - they love the family, but strangers...not so much
Extroverted - they love everyone - stranger danger who?
Adaptable - home is wherever I'm with you
How would you best describe your dog's behavior around other dogs when off-leash?
TBD - we have not observed our dogs off-leash
Life of the party - yet to meet a dog they didn't love
Full Speed Ahead - level of friendliness that can be overwhelming to others
Social - gets along with most personality types
Selective - likes some, but not all dogs. Has preferences of sex/size/playstyle
Introverted - prefers predictable, known dogs
The Come-Around Kid - starts off shy but really opens up when you get to know them
The People Dog - prefers people > dogs
Anxious - social situations can stress them out
The Chaser - loves to chase other dogs
The Chasee - loves to be chased by other dogs
The Wrestler - loves a good ruff n tumble
The Belly Flasher - tends to roll over when other dogs approach
The Referee - known to interject if someone's having too good of a time
The Body Slammer - not the greatest at respecting boundaries
The Humper - can get a little "too" friendly during play
The Lone Wolf - who needs a group when you can entertain yourself?
Unknown - we have not seen our dog off leash with other dogs
Loudmouth - Notoriously vocal/barky during play
Mouthy - play biting is my love language
The Peacekeeper - has a way of diffusing potential conflict
The Fighter - if they didn't start it, they'll finish it
How would you describe your dog's behavior around (new) people?
Social Butterfly - has never met a stranger
Greeting Party - enthusiastic greeter, but quick to calm down
The Gentleman/lady - interested in meeting new people but not overly excited
Introverted - may take awhile to win over but does eventually warm up to most
Tolerant - not necessarily thrilled to meet people, but handles the interaction well
Sniff but No Touch - curious about meeting people, but avoids touch from them
Attention Seeker - all people are clearly there for only them - may be vocal/jumpy/slap happy
The Climber - has no idea what personal space is. Takes the form of a weighted blanket or backpack
Club Captain - once youre in, youre in...but you have to work hard to get in
Anti-Social - who needs friends when you can be by yourself?
Quiet Avoidant - leaves the room/area if people approach/come over
Loud Avoidant - barks and retreats
The Bouncer - barks/charges/lunges towards visitors/strangers
How does your dog behave when on leash?
They get excited to get leashed up
They try to avoid getting leashed up
Intense pulling throughout the majority of the walk
Moderate pulling occurs
Minimal pulling occurs
No pulling occurs
Pulling occurs in some situations but not throughout
They pull excitedly towards other people
They bark/lunge towards other people
They pull excitedly towards other dogs
They bark/lunge towards other dogs
They try to chase critters
We can easily pass other dogs
We can easily pass other people
We can easily pass small critters
They put on the brakes during walks
They have an easy time responding to cues/paying attention
It's a 50/50 chance if they'll listen to me
I might as well not exist on walks
They happily eat treats
They will eat some treats but not others
They refuse treats on walks
We have not tried bringing treats on walks
Allowed/encouraged to sniff to their heart's content
Not allowed to sniff
Regularly marks/lifts their leg
Fearful, overwhelmed, anxious
Sidewalk scavenger - quick to eat things they find off the ground
What all does your dog wear for their walks?
Ex: Harness, flat collar, 6' leash, 15' leash, prong collar
How does your dog travel in the car? Please include BOTH their behavior AND what you use (if anything) to contain them
Ex: They relax easily/pacing/drooling/barking | crate/seatbelt/barrier/free-roam
List all behaviors your dog knows or is actively learning
Ex: Lay Down/Come/Leave It/Place/Drop It/Stay/Leash Manners
Which best describes your dog's ability to come when called?
Perfection - they can recall from a long distance, off of distractions like other dogs/wildlife, and in new environments
Dog-Gone Good - they recall *most* of the time, but struggle around bigger distractions like wildlife/other dogs
Unreliable - it's a gamble if they'll come when called or not. Best not to let them off-leash
Non-Existant - we aren't ready for off-leash time yet
Runaway - if the leash is unclipped, they'll dart
Has your dog ever been in an altercation with another dog? If yes, please provide incident details
Please include what happened, any injuries sustained to either party & if a vet visit was needed
Has your dog ever bitten a person? If yes, please provide incident details
puppy nipping/mouthingis excluded, unless you view it as abnormal. Please include what happened, any injuries sustained (did it break skin/ scratch/ puncture/bruise), and if any medical attention was required
Does your dog have any fears or dislikes to consider?
Ex: vacuums, men, thunder, riding in the car
Are there any other health, behavior, or personality traits that we should know about your dog?
By typing your name in the space below, you are certifying that all information is correct and completed to the best of your ability.
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