Questionnaire Form

Cori’s K9 Training Questionnaire
Please Select Service Of Interest*

General ConsultWalk This Way 2Walk This Way 4Walk This Way Day TrainingWalk This Way Puppy Day TrainingYoung Guns Board and Train
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dog's Name
Dog's Breed
Dog's Age
My Dog currently lives with: (check all that apply)

DogsCatsKidsOther adultsOther animals
Are you having difficulties with any of the above of so please provide details:
Is your dog crate trained?

YesNo
My Dog: (check all that apply)

Jumps on peopleLunges at dogsLunges at peopleDestroys bedding in crateDestroys bedding out of crateBit another dog causing damageBit another dog causing NO damageBit a person causing damageBit a person causing NO damageJumps fencesBarks on walksBarks in the yardBarks in the homeMounts people or objectsUrinates when excited or afraidIs overactive and doesn't settle easilyGrowls at family members or new peoplePlay bitesSleeps in bed with usChews destructivelyDoes not come when calledBolts through open doorsGuards toys, food, objects, etcIs shyStresses easilyPulls on leashSniffs or eats from counter tops jumps on furniture that is off limitsHas separation anxietyDigs in the yard
If your dog has bitten a human or another dog causing damage, please explain the extent of damage
Please list any other issues not listed above
Do you feed your dog at specific times or do you free feed?
Please Select all that apply

We have a fully fenced yardWe do not have a yard or it is not fully fencedWe have an invisible fenceWe live in and apartment / condoWe live in a multi-level homeWe live in a rambler / ranch style homeOther
Is your dog currently on any medication for anxiety or behaviour issues?

YesNo
What level(s) of training has your dog had?
Does your dog know basic obedience (sit, down, stay, wait, leave it )

YesNo
Additional comments or message:
Should be Empty:

Cori’s K9 Training Questionnaire