Training - Questionnaire

The Dog Patch Training Program - Client Questionnaire

Thank you for choosing The Dog Patch for your dog's training needs! To help us create the best training plan for your pup, please complete this questionnaire.
Owner's Name*
Phone Number*
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dogs Name:
Breed:
Dog's date of birth*

MonthDayYear
Date
Sex:*

MaleFemale
Spayed/neutered?*

YesNo
How long have you had your dog
Is your dog a rescue? (depending on age and/or other information, there maybe a waiting period)*

NoYes
Training Goals
1. What are your main goals for training? Select all that apply.

Basic Obedience (sit, stay, come, leash manners, etc.)Socialization with people & other dogsHousebreaking/potty trainingProblem behaviors (barking, jumping, chewing, etc.)Confidence building for a shy or anxious dogLeash reactivity/aggression managementAdvanced trainingOther
2. Has your dog received any prior training If so, what type? (Group, class private sessions, self-training, etc.) How long ago?
3. How does your do react to new people?

Friendly & outgoingShy & NervousFearful or reactiveOther
4. How does your dog interact with other dogs?

Loves to play & socializeNeutral, doesn't engage muchNervous or unsureReactive or aggressiveOther
5. Are there any specific behavioral issues you would like to address
6. Does your dog have any fears or anxieties (loud noises, separation, car rides, etc.)?
Daily Routine & Lifestyle:
7. How much exercise does your dog get daily? (Walks, playtime, etc.)
8. Does your dog have any dietary restrictions or food allergies?*
9. Does your dog have any medical conditions or take any medications?*
10. Are there any other details about your dog that would help us with training?
11. Who will be attending the training (if group or private) & relationship?
Emergency Contact Information:
Name*
Phone Number*
By signing below, I confirm that the information provided is accurate and that I understand and agree to The Dog Patch's training policies.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: