New Client
Date
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Month
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Day
Year
Date
Name
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Address
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Cell Phone
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Home Phone
Work Phone
Email
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example@example.com
How did you hear about New Vistas K9?
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Has your dog had previous training? What type?
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What goals do you want to achieve with your dog?
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Describe your Household / Family make-up.
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Are there children in your home OR that visit?
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Yes
No
Dog Name and Sex
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Breed and Color
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Age and Age Acquired
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Heartworm Medication and Date Given Each Month
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Veterinarian/Hospital, Phone Number, and Last Visit
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Medical Condition(s) Past / Present:
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Behavior Issues (Check all that apply)
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Soils House
Jumps up
People Aggressive
Runs Away
Shies
Chews
Hyper-Active
Aggressive / Fights
Doesn’t Obey
Escapes
Barges Doorways
Pulls Leash
Bites
Chases Cars
Digs
Excessive Barking
House Manners
Possessive (food/toy)
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Describe an average daily routine with your dog.
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Is this your first dog?
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Yes
No
Where did you get your dog and why did you get a dog?
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Do you own any other pets? If yes, list for each pet: Name, Type, Breed, Age, and Sex. If no, write "N/A"
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What brand of dog food do you feed your dog? How much / How often?
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Who feeds your dog and where is your dog feed?
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What treats does your dog like and how often do you treat?
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Is your dog given food scraps? Where are the dog toys kept?
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Is dog crate trained, Yes or No? Where is the crate kept?
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Does your dog exhibit aggression around the crate? How does your dog feel about the crate?
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Where is your dog kept when you are not home?
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Where does your dog sleep: 1) At Night, 2) During the Day
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How much time does your dog spend alone each day?
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How much time does your dog spend outside each day?
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Yes
No
Do you have a dog door?
Do you have a fenced yard?
Do you have a doghouse?
Is your dog allowed on furniture / in bed(s)?
Have you ever or do you currently use the physical alpha role?
What type of exercise does your dog get? How often?
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Where / Who does your dog stay with when you go out of town?
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Who grooms your dog and how does your dog respond to grooming?
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Do YOU or YOUR DOG have any physical limitations or handicaps? Please explain.
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What situations/people/dogs does your dog dislike?
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Does your dog prefer (check all that apply):
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Men
Children/Kids
Women
Male Dogs
Adults
Female Dogs
Has your dog ever urinated on you or other members of your immediate family? Yes or No? Who?
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Has your dog ever growled at you or other members of your immediate family? Yes or No? Who?
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Has your dog ever snapped at or bitten you or other members of your immediate family? Yes or No? Who?
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Has your dog ever snapped at or bitten visitors?
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Yes
No
Has your dog ever snapped at or bitten strangers?
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Yes
No
Does your dog have any fears or sensitivities? If so, please explain.
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How do you respond to and correct unwanted behaviors?
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Additional comments
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