K9 Basecamp Questionnaire

K9 Basecamp

Thank you for choosing K9 Basecamp for your Evaluation!
CANADA
Date*

MonthDayYear
Date
1. Owner Name(s)*
2. Dog's name*
3. Age*
4. Breed*
5. Sex*
6. Physical description (color/weight)*
7. Email Address*
example@example.com
8. What city/ town do you live in? *
9. Phone Number*
Format: (000) 000-0000.
10. Full Mailing Address*
11. Where did you get your dog? (Rescue/Breeder or Other)*
12. How long have you had your dog?*
13. Dog's age when it came to you?*
14. Is your dog fully vaccinated which includes: Rabies, Bordetella, Leptospirosis?*
15. Spay/Neutered?*
16. Heartworm Prev?*
17. Tick/Flea Prev?*
18. Check or Highlight Problem Behaviors:
Fence FightingStubbornSoil in HousePoor RecallToy AgressionSeparation AnxietyResource GuardingRuns AwayNipsNeedyTree ClimbingFear of Loud NoiseDog ReactiveBitesChewsJumpsBoltsDigsBarksHuman AgressionAnimal ReactiveLungingOther
19 What are your expectations of training your dog?*
20 How many people does your dog live with?
How many Adults?*
How many Children?*
20 If you have other pets, please tell us the type and age:*
21 If you have cats, how is your dog with cats?*
22 How does your dog get along with other pets in your home?*
23 Has your dog ever growled, snapped or bitten you or anyone else including another animal?*
24 Does your dog get nervous around strangers? If yes, what does your dog do?*
25 Has your dog ever shown aggression toward other dogs or pets?*
26 Is this the first dog you have owned as an adult?*
27 Do you tend to spoil your dog?*
28 Is your dog like a child to you?*
29 Do you think your dog has gotten mad at you? And what happened?*
30 Do you think your dog has done anything spiteful? *
If so what has it done*
31 Are you consistent in your expectations of training your dog?*
32 Does your dog get upset when you leave it alone? What does it do?*
33 Do you confine your dog room crate yard etc away from you? if so, why?*
34 Do you have to repeat commands to get your dog to respond?*
35 How do you tend to discipline your dog? Does it work?*
36 Do you punish your dog If so how?*
38 Is your dog potty trained?*
39 Have you punished your dog for soiling in the house?*
40 Does your dog live in the house? If not where/why?*
41 Is your dog allowed on furniture?*
42 Does your dog sleep in your bed? If yes, how often?*
43. How many minutes/hours a day do you think your dog gets exercise?*
44 How many walks on leash does your dog get a week?*
45 Do you allow your dog off leash? If so where?*
46 Does your dog come back when called?*
47 Do you have a fenced-in yard?*
48 How is your dog in the car?*
49 How did you hear about us? if it someone we know, we'd love to say, THANK YOU!*
Should be Empty:

K9 Basecamp

CANADA