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  • Client and Canine Information Questionnaire

    This form must be completed and submitted prior to consult/first appointment.
  • I greatly appreciate you taking the time to complete this questionnaire. The information will be used solely to review your dog’s history and to help me prepare a plan for training or behavior modification.

    Please review this entire questionnaire first, then go back and answer the questions as thoroughly as possible. If there was an incident (such as a bite), please ask anyone who witnessed the bite incident for their input as well.

    The information contained herein will only be shared with another trainer, veterinarian, veterinary specialist or veterinary behaviorist with your permission.

  • Additional Household Members

  • Pet Information

  • Tell Me ABout Your Dog

  • Medical Information:

  • Dietary Information

  • General Information

  • Life Skills & Manners







  • Fearful, Aggressive, Reactive Behaviors





  • Bite Incident(s)

    This does NOT include the appropriate use of your dog's mouth in the course of appropriate play 

    If your dog has threatened and/or bitten a person or animal, whether or not there was an injury, you MUST complete a Bite Event Questionnaire for each incident.

    Air-snapping, grabbing another dog without inflicting injury, a nip that doesn't break skin are just some examples of what you may not consider a bite, but they are.

  • Help for Your Dog


  • By selecting the “I agree” button, I am signing this document electronically. I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document. I further agree that my signature on this document is as valid as if I signed the document in writing. 

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  • Please visit my website to learn more about my training, education, methods, skills, credentials and history

    www.theinnerdog.com

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